The Problem With Mail-Order Prescriptions: Inappropriate Med Use and Pharmacy Benefit Manager Abuses

June 15, 2009

(As submitted to Money Magazine)

To the Editor:

A recent article ("Beat the Rising Cost of Health Care," July 2009) only told half the story about mail-order medicine.

Reading the fine print shows that mail-order often costs far more than medications dispensed by licensed pharmacists. The reason? Prescription drug plans are administered by pharmacy benefit managers, companies that charge plan sponsors (e.g. employers) hefty fees to run mail-order programs. The "spread" between what mail-order companies charge and what they pay for drugs is so enormous that they're willing to take a loss on the front end (the lower co-pays cited in the article). Collectively, these costs dwarf a retail pharmacy's overhead and, ultimately, they are borne by employers and patients in the form of higher insurance premiums.

In addition, it's been estimated that $177 billion is spent annually on hospital, physician and other treatments for inappropriate medication use. Swapping community pharmacists for envelopes and 1-800 numbers would almost certainly drive up the human and financial toll of adverse drug events.

Patients hoping to restrain drug costs should consult their community pharmacists, who see every day how families struggle to pay for essential medicines. They may be able to make recommendations to save patients money while ensuring they use their medications as safely and effectively as possible.

Bruce T. Roberts
Executive Vice President and CEO
National Community Pharmacists Association
Alexandria, VA

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