Survey: Medicare Beneficiaries Oppose Mandatory Mail Drug Plans

Published Online: Thursday, January 24, 2013
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PRESS RELEASE

Alexandria, Va. - Jan. 24, 2013 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 today by the National Community Pharmacists Association (NCPA).

Nearly two-thirds of seniors (63 percent) indicated they were fearful of losing access to the pharmacy of their choice if they were required to use mail order. In addition, a plurality 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.

"Mail order is not for everyone. In fact, consumers have said that it's not for most people. Patients deserve a choice and they don't like being told which pharmacy they have to use," said NCPA CEO B. Douglas Hoey, RPh, MBA. "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. Second, employers and other sponsors of private health plans that require the use of mail order should reconsider their prescription drug plan's design."

Hoey continued "denying seniors, many of whom are on complex medication regimens, the right to obtain medication from the pharmacy of their choice and from a pharmacist they trust deprives them of vital face-to-face consultation with one of their healthcare providers. Local pharmacists help to reduce medication waste that may be associated with mail order, auto-ship programs. 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, they 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 percent of respondents were concerned about losing access to the pharmacist they trust.
  • Medication waste generated through mail order concerned 41 percent of respondents.
  • Four out of five seniors (83 percent) 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 percent 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.
  • Most respondents (57 percent) were personally familiar with mail order pharmacies, having used them at some point.

About one-third of respondents (35 percent) submitted handwritten comments in addition to their completed surveys, and 82.7 percent of these comments contained one or more concerns and/or negative attitudes toward mail order pharmacy. Comments included the following:

  • "I now am required to use a mail order pharmacy. Service is poor, we travel, they mail it to the wrong address (I give clear and precise directions on where drugs are to be mailed). You never know for sure when or if your drugs will arrive. Long waits on the telephone. Almost impossible to talk to a real person. I much prefer using a local pharmacy or chain pharmacy due to the past poor experiences with mail order."
  • "My rural postal delivery is made to a box 600 ft. from my house. Since delivery times are not consistent, I could not be alert to the prescription arrival. I cannot see the box from my house. I have experienced not receiving my mail order prescription when they were ordered in sufficient time. Thank God for my local pharmacist."
  • "I used mail order for a time. My order was lost. I had to get new prescriptions filled at a local pharmacy. I never received that lost order. I learned later, it went to a city with a similar name. Mail order was not worth the trouble it caused me. At times you need a prescription filled immediately and not have to wait days or weeks to receive it by mail."
  • Click here for more patient comments.

The findings of this survey echo those of other recent surveys. The J.D. Power and Associates 2012 U.S. Pharmacy Study showed satisfaction among mail order customers to be declining and significantly lower than customers of brick and mortar pharmacies. A 2012 Walgreens survey found that four out of five patients prefer to obtain their medications at a retail pharmacy over mail order. Some common patient complaints about mandatory mail order were portrayed in an online video entitled "Mail Order Madness" that has garnered thousands of views on YouTube.

Public sentiment is clearly against mandatory mail order plans. In recent years New York and Pennsylvania 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. NCPA will continue to advocate for prescription plan designs that offer patients a choice in pharmacy and that allow patients to select pharmacy providers that best suit their individual needs.

About the Survey: The survey was conducted by MENTORx on behalf of the National Community Pharmacists Association to survey the attitudes of Medicare-eligible Americans toward the implementation of mandatory mail-order pharmacy services in their prescription benefit plans. The survey was mailed to a random sample of 6,500 Medicare beneficiaries and results are based on the 669 completed surveys returned during the data collection period of November-December 2012. The average age for respondents was 72.4 with women submitting 57% of the completed surveys. Overall, the returned surveys represent 644 ZIP codes in 43 states.

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