NCPA: Mandatory mail raising 'serious concerns' among seniors

ALEXANDRIA, Va. — Seniors have serious concerns regarding mandatory mail-order pharmacy requirements in prescription drug plans, according to a new national survey of 669 Medicare Part D beneficiaries released Thursday by the National Community Pharmacists Association.

"Mail order is not for everyone. … Patients deserve a choice and they don't like being told which pharmacy they have to use," stated Douglas Hoey, NCPA CEO. "The findings of this survey should be a significant red flag for policymakers. First, policymakers should oppose requirements or further inducements to steer patients to mail order pharmacies against their preference," he said. "Second, employers and other sponsors of private health plans that require the use of mail order should reconsider their prescription drug plan's design."

Nearly two-thirds of seniors indicated they were fearful of losing access to the pharmacy of their choice if they were required to use mail order. In addition, a majority of seniors expressed concerns about using mail-order pharmacies, including running out of their medications; obtaining prescriptions in a timely manner; lost, stolen or damaged medications; and the ability to consult with a pharmacist they know and trust.

The opportunity for that face-to-face consultation with a pharmacist that a patient has when patronizing a community pharmacy helps to reduce medication waste that may be associated with mail-order, auto-ship programs, Hoey noted. "They also provide services unique to the community, such as offering same-day home delivery or fulfilling patient-specific requests. These services not only benefit the patient, but also benefit the healthcare system by reducing the number of preventable, bad outcomes that often lead to costly hospitalizations or emergency room visits that drive up healthcare costs."

Other key findings from the survey responses include:

• If required to use mail order, 55% of respondents were concerned about losing access to the pharmacist they trust;
• Medication waste generated through mail order concerned 41% of respondents;
• As many as 83% expressed opposition to mandatory mail order if it would force their community pharmacy to close;
• Beneficiaries also opposed mandatory mail order policies if there were a greater than 40% chance that the requirement would force the local pharmacy to close;
• Among those who currently use either a voluntary or mandatory mail-order option, respondents indicated they speak to a mail-order pharmacist once every six months—just 2.1 times per year, on average; and
• Most respondents (57%) were personally familiar with mail order pharmacies, having used them at some point.

NCPA noted that in recent years both New York and Pennsylvania have enacted laws giving many patients the ability to transfer prescriptions from mail order to a local pharmacy that agrees to accept the same pricing terms and conditions.