Mail-Order

Impedes a health plan’s ability to direct patients to a mail order pharmacy for chronic care medications.

OIG/TRICARE Study: The TRICARE Mail Order Pharmacy Program Was Cost Efficient and Adequate Dispensing Controls Were in Place (July 2013)

The aspects of the TMOP program examined were cost efficient relative to the retail pharmacy option. TMA’s cost analysis showed that filling prescriptions through the TMOP program was generally more cost efficient than through retail pharmacies. Although some costs, such as waste and pharmaceuticals returned for destruction, were not included in the analysis, the effect was insignificant. In addition, adequate controls over dispensing pharmaceuticals through the TMOP program were in place based on our review and observation of dispensing operations, prescription error rates, pharmaceutical returns, and beneficiary satisfaction surveys. Overall, the TMOP program was more efficient and effective than retail programs, providing cost savings to DoD and potentially reducing health risks associated with dispensing incorrect pharmaceuticals.

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PA – Milliman Study: Potential Cost Impact of Proposed Pennsylvania House Bill 814 On Purchasers of Insured Prescription Drug Benefits (May 2006)

Prohibiting mandatory mail-service benefits would reduce the usage of mail-service pharmacies.
Eliminating the copayment differential would eliminate financial incentives consumers have for
utilizing mail-service. Combined, these provisions will have the effect of reducing or
eliminating the mail-service distribution channel. Reducing or eliminating mail-service
prescription drug distribution would result in greater costs for the purchasers
and consumers of insured prescription drug benefits in Pennsylvania.

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