Most local pharmacies will hand-deliver at scheduled times in temperature-controlled vehicles for free.
With the local public health threat, many patients are being told to stock up on at least 2 weeks of medications. Sadly, for many of us, we are not able to do this for our children or for ourselves.
Why?
Recently, I spoke to a state representative who appeared to shrug off our concerns about temperature issues and delays with mail-order pharmacy. Knowing my child’s life was risked, this was hard for me to hear. She stated that her seniors loved the 90-day supplies at their mail-order pharmacy.
My question to her was, “Why are patients not allowed to receive a 90-day supply locally at our local pharmacies that hand-deliver in temperature-controlled vehicles for free? Mail-order through UPS, USPS, or Fed-Ex could be an option but shouldn’t be forced as there are many risks. Shouldn't we be prioritizing and rewarding safety?
After a moment of silence, the conversation shifted.
Here is the answer to that question.
Pharmacy benefit managers (PBMs) and insurance companies play a major role in limiting the patient's choice of pharmacy. Three PBMs are CVS Caremark, Optum RX, and Express Scripts who own their own pharmacy that they force patients to. All three have merged with health insurance companies. The insurance companies and pharmacy benefit managers play a role in the number of days or refills that medications will be approved for at their own pharmacies and their competitors' pharmacies. Not only do they assist in setting the price that patients pay at their own pharmacy, but insurance companies and PBMs also help determine the price that you will pay at a competitor’s pharmacy. They deal themselves a winning hand by ensuring that often only their pharmacies can process 90-day refills, fill specialty medications, and offer lower copays. Keep in mind that even with a $0 copay through their steering, PBMs have been price-gouging patients, taxpayers patients, and employers behind the curtain.
Sadly, I wanted to prepare for the future of possibilities of a drug shortage or epidemic and recently called to see how much prescription medications would be for a 90-day supply. The cost of my child’s medications would be around $2000. Our insurance wouldn’t cover a 90-day supply at my local pharmacy.
The only way to receive coverage for a 90-day supply of our child's life-saving medications would be to place his life back in the hands of a pharmacy that risked his life with improper temperature control of his transplant medications. After many contradictory statements, I don't trust them with his life.
The 90-day option of refills at mail-order only is one of the many tools that PBMs use to put our local trusted pharmacies out of business.
At this time, some patients are transferring their medications to mail-order in order to receive extra weeks of supply in case of an outbreak of a virus in their area.
Knowing the many risks with mail-order pharmacy and the importance of the relationship with a pharmacist, I’m concerned about these patients and the devastating effects on our communities as pharmacies close.
Local pharmacies can most safely hand deliver when necessary without terminating the relationship with the pharmacy staff during such a crisis.
America can only hope that the Coronavirus Covid-19 is contained. In the meantime, we must realize the crucial importance of our local pharmacies. In many towns, pharmacists are the only healthcare providers available for many miles. Local pharmacists do more than deliver a bag of medications, they provide crucial counseling, demonstrate how to use complex medications, they keep a crucial relationship with our local physicians, prevent drug interactions, and administer vaccines. Due to the unethical acts of PBMs steering to their own pharmacy and purposefully reimbursing pharmacists below the costs of medication, some counties in the US are down to only 1 pharmacy in an entire county. Some patients have complained about having to drive over 30 miles for medications such as antibiotics. It doesn't have to be this way.
In a past pandemic of the 1918 Spanish Flu that was very widespread across our nation, mail-delivery was delayed and in some areas, the delivery of mail was halted due to the widespread number of postal workers who became ill. I trust that our local pharmacies would do what it would take to get the medications to their patients in such a crisis. Will the PBMs and their own mail-order pharmacies?
The mail-order pharmacies have already failed America in ensuring that medications were delivered in a way that medications could become harmful or ineffective and ensuring that patients didn’t have to risk their lives with delays, thefts, or unnecessary damages. Currently, when these issues occur the mail-order pharmacies blame the mail delivery service. Soon, the mail-order pharmacies' ability to act during such a crisis may be determined.
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