Mail Order is not for Everyone!
Face-to-face pharmacist/patient counseling can have a powerful impact on long-term health care costs and quality. So, the way health plan sponsors use and promote mail order is crucial, because the wrong way could undermine more impactful savings strategies such as improved patient adherence and increased generic utilization.
"They aren't loyal customers. They're hostages, and they don't like it." – J.D. Power and Associates official describing patients in mandatory mail order pharmacy plans, Drug Topics article, Mar. 2010.
Study after study has shown that health plans that subsidize patient co-payments for drugs purchased from PBM-owned mail order dispensing to encourage the use of mail order actually pay more for drugs.9, 10, 11
Many pharmacy benefit consultants, the pharmacy cost experts health plan sponsors pay for advice, agree with these studies' findings.13
- Plans offering no mail-service co-payment incentives have a 6.6% - 18.7% lower cost share10
- The study's conclusions were consistent with previous studies and examined plans that utilized co‐payments as an incentive for members to use mail‐service pharmacies.9, 11
- These plans paid more for mail service medications; between 4.5% - 8.3% more overall.10, 11
- Plans promoting mail with co-payment incentives paid 21.4% - 25% more for generic drugs.10
- PBM SEC Reports between 2007 - 2010 state that generic dispensing ratios were lower in the mail-order channel than in the community pharmacy channel by 10.3% - 11.3%
- Over 96% of health plans offer mail order service for maintenance medications, but only about 19% mandate the use of mail order5
- PBMs will not guarantee on a dollar-for-dollar basis mail order promised savings because savings are seldom achieved
- Year-over-year mail order growth as a percentage of total prescriptions remains flat to negative because patients prefer retail channel
MAIL ORDER ADVOCACY RESOURCES