ALEXANDRIA, Va. — Senior citizens aren’t comfortable with mandatory mail order for their prescriptions, a national survey commissioned by the National Community Pharmacists Association reveals.
NCPA said Thursday that the poll of 669 Medicare Part D beneficiaries, conducted by MENTORx, finds that 63% of seniors are concerned about losing access to the pharmacy of their choice if required to use mail order.
And that concern also extends to the pharmacist. If required to use mail order, 55% of seniors indicated they would be worried about losing access to the pharmacist they trust.
"Mail order is not for everyone. In fact, consumers have said that it’s not for most people," NCPA chief executive officer B. Douglas Hoey said in a statement. "Patients deserve a choice, and they don’t like being told which pharmacy they have to use."
More than four out of five seniors polled (83%) expressed opposition to mandatory mail order if it would force their community pharmacy to close. NCPA noted that Medicare beneficiaries also opposed mandatory mail order if there were a greater than 40% chance that such a policy would force their local pharmacy to close.
Seniors who said they now use a voluntary or a mandatory mail-order option reported that they speak to a mail order pharmacist once every six months, just 2.1 times per year, on average. Fifty-seven percent of respondents were personally familiar with mail order pharmacies, having used them at some point. Medication waste generated through mail order concerned 41% of seniors surveyed.
"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 health care providers," Hoey explained. "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 also benefit the health care system by reducing the number of preventable, bad outcomes that often lead to costly hospitalizations or emergency room visits that drive up health care costs."
NCPA said 35% of respondents also submitted handwritten comments, and 82.7% of the comments included 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."
• "It [loss of local pharmacy] would upset me very much. I would miss the personal relationship I have with my pharmacist. I can ask him questions and get information concerning adverse reactions. Timing of my medication and I trust him. It’s a one to one relationship."
• "It is very important to keep and maintain viable community pharmacies. Rx customers need choices to have access to a local pharmacy."
• "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."
According to NCPA, public opinion is against mandatory mail-order pharmacy benefit plans. In recent years, New York and Pennsylvania enacted laws enabling many patients to transfer prescriptions from mail order to a local pharmacy that agrees to accept the same pricing terms and conditions, the association noted.
"The findings of this survey should be a significant red flag for policymakers," Hoey stated. "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."
NCPA added that a Walgreens study released last April found that four out of five patients prefer to get their medications at a retail pharmacy over mail order. In addition, the J.D. Power and Associates 2012 U.S. Pharmacy Study showed that satisfaction among mail order customers has declined and is lower than that of customers of brick-and-mortar pharmacies.
