Mail Order Isn’t Cheaper

bluecross Mail Order Isn’t Cheaper, Study Finds

new NCPA study of millions of Medicare Part D prescription drug event data has found that community pharmacies dispense 90-day medication supplies at lower overall cost than mail order pharmacies. The study further concluded that community pharmacists substitute generic drugs more often when compared to mail order pharmacies.

Norman V. Carroll, PhD, a professor at Virginia Commonwealth University, reviewed PDE records for 2010 that were supplied by the Centers for Medicare & Medicaid Services. His analysis found:

  • For 90-day prescriptions filled by community pharmacies, costs per unit of medication, as compared with mail order pharmacies, were lower for total costs ($0.94 vs. $0.96), Medicare costs ($0.59 vs. $0.63), and all third-party payer costs ($0.64 vs. $0.72). Because of co-pay differentials set by health plans to incentivize mail order usage, patient costs at retail were higher ($0.31 vs. $0.24 at mail order) even though the total cost of those prescriptions was less at retail.

  • Appropriate substitution of generic drugs for brand-name drugs in 90-day prescriptions occurred more often in community pharmacies—91.4% of the time vs. 88.8% at mail order.

“This study blows a huge hole in the PBMs’ arguments that more mail order is the right prescription for Part D savings,” said NCPA CEO B. Douglas Hoey, Pharmacist, MBA. “For policymakers and health plan sponsors, to whom we are circulating this study, these findings point to several recommendations. First, allow local pharmacies to fill 90-day prescriptions. Second, don’t adopt co-pay levels that incentivize the use of mail order pharmacies based on exaggerated and illusory cost-savings claims.”