Pending legislation in Pennsylvania would help level the playing field between community pharmacies and mail-order pharmacy services run by pharmacy benefit managers, according to the National Community Pharmacists Association.


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Pennsylvania bill takes aim at mail-order pharmacy

September 28th, 2012

ALEXANDRIA, Va. – Pending legislation in Pennsylvania would help level the playing field between community pharmacies and mail-order pharmacy services run by pharmacy benefit managers, according to the National Community Pharmacists Association.

NCPA said Thursday that under S.B. 201, Pennsylvania consumers would get more lattitude to choose to go to a local retail pharmacy instead of being required to use a mail-order pharmacy for their prescriptions.

According to the association, the bill would allow independent pharmacies and other pharmacy providers to match the reimbursement terms and conditions that mail-order pharmacies, typically owned by PBMs, negotiate with health insurance plans.

NCPA noted that research from Walgreen Co. shows that four out of five patients prefer to use a community pharmacy instead of mail order. Yet many health plans require patients to use mail order or subsidize the use of mail-order pharmacies in the form of discounted patient co-payments, NCPA said, explaining that S.B. 201 would allow local pharmacies to be part of such arrangements, giving patients greater choice of pharmacy at the same net cost.

The association also pointed to pharmacy research released this week by J.D. Power and Associates indicating the customer satisfaction with mail-order pharmacies has continued to decline, while patient satisfaction with retail pharmacies — especially independent pharmacies — remains strong.

"S.B.201 will simply allow consumers to have the freedom of choice they deserve when choosing how to access their healthc are needs," NCPA stated in a letter to Pennsylvania lawmakers. "It will allow citizens to gain the benefit of face-to-face interaction with their trusted community pharmacist if they choose to do so, instead of being forced to utilize an out-of-state mail order pharmacy."

Earlier this week, however, the Pharmaceutical Care Management Association (PCMA) said the Pennsylvania legislation's aim to prohibit mail-service pharmacies from charging less than drug stores would hike health care costs for employers and consumers in the state by more than $570 million over the next 10 years.

PCMA, a trade organization for the PBM industry, also reported that the Pennsylvania Employee Benefit Trust Fund found that "such restrictions on the use of mail-order pharmacy would increase costs to the state employees benefit plan by $47.5 million in the first year of implementation."

"This prescription drug tax is bought and paid for by the drug store lobby and will raise health costs for small businesses, unions, government agencies and consumers," PCMA president and chief executive officer Mark Merritt said in a statement. "In this economy, employers need every cost-saving tool they can get and mail-service pharmacy is at the top of the list."

According to PCMA, mail-service pharmacies offer deeper discounts and reduced co-pays compared with brick-and-mortar drug stores. The association also said mail-order pharmacies save consumers and payers an average of 15% on 90-day prescriptions versus at drug stores.

PCMA also noted that home delivery is popular with patients because it's more convenient than driving to the drug store and that nearly eight of 10 small businesses want to be able to continue offering discounts that encourage employees to use the mail-service pharmacy option. The group added that consumers who use home delivery are strongly satisfied with it and, with mail-service pharmacies, patients can get counseling over the phone from trained pharmacists 24 x 7.

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