May 6, 2013
As policymakers examine ways to reduce health care costs, a recent study finds that the vast majority of prescription medication waste in Medicare Part D occurs at local drugstores, not mail-service pharmacies. Mail-service pharmacy prescriptions account for just 0.02% of “waste” in Medicare Part D, according to a study from Visante released by the Pharmaceutical Care Management Association (PCMA).
“Though policymakers want less spending and more accountability, the drugstore lobby plan would raise costs, reduce accountability, and trigger an avalanche of wasteful spending. That may be good for the drugstore lobby, but it’s bad for the employers and government health programs that foot the bill,” said PCMA President and CEO Mark Merritt.
Major findings from the study—“Myths and Realities of Medication Waste in Medicare Part D”—include:
- Less than 1% of all medications dispensed for Medicare beneficiaries are wasted.
- More than two-thirds of medication wasted in Medicare is dispensed by drugstores.
- Mail-service pharmacies are typically used only after a patient has already been stabilized on several 30-day prescriptions dispensed by a local drugstore.
- Waste related to mail-service “auto-refill” prescriptions accounts for just 0.02% of medication dispensed in Part D.
Mail-Service Pharmacies: Savings, Safety, and Increased Adherence
U.S. Representatives Tout the Value of Mail-Service Pharmacies. In a recent letter to United States Postmaster General and Chief Executive Officer Patrick Donahoe, 88 members of the United States House of Representatives urged the Post Office to continue delivering medications six days a week and touted the benefits of mail-service pharmacies:
“In our home districts, Medicare, Medicaid, TRICARE, VA and other beneficiaries currently rely on low cost delivery of prescription drugs to their doorstep. Whether it is a homebound senior that cannot walk or drive to the pharmacy, or a Veteran who lives in a rural area with limited access to the prescription drugs they need, all of these home delivery beneficiaries cannot afford to go without their medications for days. Nor should they have to obtain their medications through more costly delivery methods, which would only draw business away from the USPS and threaten its long term financial stability.
“This growing population of home delivery prescription beneficiaries is not only good for the USPS and patients, but our government as a whole.”
National Center for Policy Analysis. A new report from the National Center for Policy Analysis, “Unnecessary Regulations that Increase Prescription Drug Costs,” warns federal and state policymakers to avoid enacting laws that undermine payers’ ability to use mail-service pharmacies, preferred pharmacy networks, and other innovative pharmacy benefit management (PBM) tools.
Mail-Service Pharmacies Save $46.6 Billion. Mail-service pharmacies can save Medicare seniors, employers, unions, government employee plans, consumers, and other commercial-sector payers $46.6 billion in prescription drug costs over the next ten years, according to a 2012 study.
National Community Pharmacists Association. The independent drugstore lobby’s own poll released earlier this year found that seniors by a 3-1 margin (51-17) agree mail-service pharmacies cost less than community drugstores.
The Federal Trade Commission (FTC). The FTC concluded in a 2005 report that PBM-owned mail-order pharmacies offer lower prices on prescription drugs than retail pharmacies and are very effective at capitalizing on opportunities to dispense generic medications.
The Journal of General Internal Medicine. In a 2011 report, the Journal of General Internal Medicine found that patients receiving their prescription medications through a mail-service pharmacy achieved better cholesterol control compared to those who obtained their statin prescriptions from their local pharmacy.
American Journal of Managed Care. Consumers receiving their prescription medications for chronic conditions through a mail-service pharmacy “were more likely to take them as prescribed by their doctors than did patients who obtained them from a local pharmacy.”
Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy. Peer-reviewed data found that highly automated mail-service pharmacies dispensed prescriptions with 23 times greater accuracy than retail pharmacies. The mail-service error rate was zero in several of the most critical areas, including dispensing the correct drug and dosage.
Polling: Consumers and Employers are Satisfied with Home Delivery. A survey of small businesses found that nearly eight-out-of-ten small businesses want to be able to continue offering discounts that encourage employees to use mail-service pharmacy while consumers who use home delivery are strongly satisfied with it.