Mail-Order Melee: Patient Satisfaction Surveys at Odds

The answer to the question of whether patients are happy with mail-order pharmacies depends on who is asking. According to an annual survey by J.D. Power and Associates, mail-order pharmacy customers aged 65 and over are satisfied with their experience, rating it an average of about 844 on a scale of 1000. Survey results released the following day by the National Community Pharmacists Association (NCPA) showed nearly half of mail-order pharmacy patients experiencing problems.

"These survey results should make employers and other health plan sponsors think twice before imposing a mandatory mail-order requirement on their patients," said Bruce Roberts, NCPA executive vice president and CEO. "Mail-order programs claim to provide patients greater convenience and lower cost. In fact, patients say they have to wait too long for their drugs and some are paying twice for them."

The NCPA survey was displayed on pharmacy counters for patients to complete on a voluntary basis. About 400 patients responded, with about 48% reporting having to go without medications due to late delivery by mail-order pharmacies. Of that group, 85% stated that they had regularly paid twice for a prescription because of late delivery, having to go to a pharmacy to obtain their medications. Due to these and other negative experiences, 81% of respondents reported that they "strongly" or "somewhat" oppose mail-order pharmacy use being made mandatory for health plan participants.

Following closely on the heels of the NCPA survey was a press release from the Pharmaceutical Care Management Association (PCMA) in which the group, which is the national association that represents pharmacy benefit managers (PBMs), made its views on the differing results known.

"One day after J.D. Power and Associates released its national survey, the independent drugstore lobby has attempted to undermine it with a release of its own," the PCMA release stated. "Unfortunately for NCPA, this forces policymakers to choose which source is accurate: America's foremost consumer research firm, or a lobbying organization committed to higher pharmacy costs. Both can't be right."

On the other side of the debate, NCPA questioned the motives of PBMs, pointing out that these groups have the power to set prices for themselves and for their retail pharmacy competition. "... PBMs routinely stack the deck in favor of their mail-order providers and against community pharmacies," an NCPA release stated.

According to PCMA, Congress has the ability this year to save billions by doing away with regulations that restrict home delivery of medications through Medicare. "Savings from broader use of mail-service pharmacies could be used to offset the AMP [average manufacturer price] payment increases being so aggressively pursued by NCPA and others," PCMA asserted.

Urging that any public option health plan be overseen by "a more transparent and accountable model" than PBMs, NCPA stated that the pharmacy benefit administrator under Medicaid would provide such accountability.

"It's common for PBMs to charge a plan sponsor a much higher amount than it would a community pharmacy for dispensing the same prescription-pocketing the difference and passing those higher costs on to health plan sponsors, and ultimately patients, without disclosing them."

For other articles in this issue, see:

Pharmacists Refused Risky Rxs for Anna Nicole Smith

A Shot for the Heart: Flu Vaccine Protects Cardiac Patients

Pharmacy Weighs In as Senate Closes In on Health Reform