Mail delays expose pitfalls of prescription home delivery

The recent delays with the U.S. Postal Service have exposed a pitfall with mail-order prescription drug plans: some people aren't getting their meds on time, Shelby Livingston reports for Modern Healthcare.

Some health-insurance plans require patients to fill long-term medications by mail, and some rural residents may prefer that since they live far from pharmacies or lack transportation, Livingston reports. Some evidence suggests that receiving meds by mail increases the likelihood that patients with chronic diseases will take their meds. But that can only happen when medications show up on time and undamaged.

"AllianceRx Walgreens Prime, a home delivery venture between Walgreens and PBM Prime Therapeutics, said prescriptions have taken longer to be delivered by the USPS since March, and the company is monitoring how those delays affect patients. In some cases, delivery has been significantly delayed by three or more days," Livingston reports. "AllianceRx attributed the delays to the covid-19 pandemic, aircraft availability, significant network volume and the USPS elimination of overtime. It said it is evaluating soon-to-be-implemented postal rate increases and is looking at other mail delivery options if delays worsen. Alliance sends most prescriptions through the USPS, but also uses DHL E-Commerce to sort and enter shipments to the USPS, which helps speed up the process, it said."

The House Energy and Commerce committee said it will investigate how Postmaster General Louis DeJoy's changes have affected prescription-drug delivery. But pharmacist trade groups say the issues aren't new, and that mail-order prescriptions are prone to delays or other problems that can make it hard for patients to stay medicated.

"Even before the slowdown there was some unpredictability in the shipment of medications," B. Douglas Hoey, CEO of the National Community Pharmacists Association, told Livingston. He said that auto-shipments sometimes get lost in the mail, and that during slow-downs, medications are sometimes exposed to unsafe temperatures. "When patients experience mail order issues, the burden falls on local pharmacies that end up filling emergency supplies of medication," Livingston reports. "But those local pharmacies likely won't be reimbursed for that work, he said."

Local, independent pharmacies may lose out in another way over mail-order prescriptions, said Scott Knoer, CEO of the American Pharmacists Association. He told Livingston that he worries that, when pharmacy benefit managers require members to deliver prescriptions by mail, it can hurt the bottom lines of local pharmacies and help drive them out of business.