June 24, 2014
Mail-service and specialty pharmacies will save California consumers, employers, unions, and government plans $1.8 billion on prescription drug costs in 2015, according to new research from Visante released by the Pharmaceutical Care Management Association (PCMA).
However, these savings are at risk because of new legislation (AB 2418) backed by the California drugstore lobby that would bar employers, unions and other payers from accessing plans that automatically deliver refills to employees using chronic and specialty medications. While this would fulfill a long-term goal of the California drugstore lobby, it would threaten savings and safety benefits for many employers and patients.
“This bill profits the drugstore lobby by eliminating a safer, more affordable pharmacy option that many employers have embraced,” said PCMA President and CEO Mark Merritt. “Automatic home delivery of refills is among the easiest, most popular ways to reduce pharmacy costs. Many employers and patients see it as a much better option than cutting benefits or raising premiums.”
Major findings from the new study include:
- Mail-service pharmacies will save an estimated $500 million for California consumers, employers, and other payers in 2015, and $5.9 billion over the 10-year period 2015-24.
- Specialty pharmacies will save an estimated $1.3 billion for California consumers, employers, and other payers in 2015, and $24.9 billion over the 10-year period 2015-24.
- Combined, mail-service and specialty pharmacies will save an estimated $1.8 billion for California consumers, employers, and other payers in 2015, and $30.8 billion over the 10-year period 2015-24.
The study highlights how mail-service pharmacies:
- Provide superior safety as opposed to brick-and-mortar drugstores;
- Encourage generic drug use;
- Improve patient adherence;
- Increase efficiency;
- Offer patients access to 24/7 counseling and support; and
- Minimize “waste” that occurs at drugstores.
Specialty Pharmacies Must Meet Strict Safety Requirements
The study also details that injectable biologic medications often require special handling, clinical protocols, and can cost many thousands of dollars per dose. As a result, the Food and Drug Administration (FDA) and manufacturers have established strict distribution, use, and safety requirements. These requirements include:
- Adhering to rigorous storage, shipping and handling standards to meet FDA product label shipping requirements, such as temperature control, and timely deliveries of the product in optimal condition;
- Providing round-the-clock access to pharmacists, nurses and clinicians dedicated to and specially trained with respect to the disease state treated by the drug, the specialty drug, and the drug’s potential side effects;
- Performing disease-specific and drug-specific patient care management services that meet the unique needs of each patient and that incorporate multiple safeguards when dispensing and delivering the drug to ensure patient safety;
- Collecting data and tracking outcomes for specific patients as required by the FDA; and
- Managing compliance and persistency of drug regimens for patients.
A national survey of physicians who prescribe specialty medications found that just 5% believe that all drugstores “have the expertise and capability to provide the different types of specialty medications to patients.” In addition, a recent report on specialty pharmacies notes that “specialty drugs require a level of experience and expertise that most drugstores simply do not possess.”