Delays of Mail-order Medications Are Not New But Worsening Quickly

This week has been a tough yet hopeful week as I've watched the social media post for patients forced to mail-order pharmacy and left without medications go from 20-40/day to 1000s. Patients forced to mail-order pharmacy have had these issues for years. For many, they didn't want to risk delays and interruptions in treatment, but their insurance company, which often owns the mail-order pharmacy that they force patients to, wouldn't allow them to use their local pharmacy unless they could afford to pay 100% for some medications. 

CVS Caremark may allow for patients to use their local CVS, but the poor working conditions for pharmacists, as pointed out by the New York Times, have resulted in patients' lives risked and patient harm. One CVS pharmacy had a 22% error rate. I support improved working conditions for these pharmacists, but no one should be forced to such poor quality of pharmaceutical care. Aetna has merged with CVS Caremark and CVS Specialty Mail-order Pharmacy.

As the insurance company often owns the mail-order pharmacy & forces patients to their own that pharmacy, they also have poor ratings. For example, Cigna owns Express Scripts. Many of Cigna's patients must use Express Scripts, although they have a D-rating on the BBB. Low ratings and reviews for Aetna/CVS Specialty and United Healthcare/Optum RX are not surprising. All have merged as they use their power to force patients to be collateral damage for their skyrocketing profits.

With the many delays, few are mentioning the issue of improper temperature storage that continues to be unregulated by the FDA and poorly regulated by the State Boards of Pharmacy, whose members often have a conflicting interest. No one is warning the patients whose meds are delayed that their medications will not be temperature controlled! NBC published yesterday that the back of the UPS trucks reaches temperatures of 150 degrees. Last summer, a USPS worker cooked steaks in their vehicle. The same can happen to mail-order medications, shipped mostly in bags, and the appearance may not change as they lose potency or become toxic.

I don't believe that Americans can’t afford to provide safer pharmaceutical care. Insurance companies and their pharmacy benefit managers will deceptively claim that patients cannot use the local pharmacies because it would raise the cost. That’s because they can set the price that patients pay at their competitors' pharmacy counter. They are quick to put their own value on lives, but before and during this pandemic, the insurance company's profits are skyrocketing. Profits are doubling as they either remove patients' safe access to their local pharmacy that often offers free delivery in temperature-controlled vehicles reimburses their own competition, local pharmacies, below the cost of medications creating pharmacy closures during the pandemic.

As pharmacies try to fight back for their right to serve their communities, there is a Supreme Court Case Rutledge vs Pharmaceutical Care Management (PCMA). PCMA is the association for Express Scripts, OptumRX, CVS Caremark and they are fighting for their unethical right to purposefully reimburse local pharmacies or their own competition purposefully below the costs of medications as the CEO of CVS makes 36.5 million dollars a year. The local pharmacists are just asking to break even.  

Seeing the delays, it's heartbreaking but motivational.  I’m blasting Twitter with information to warn patients about the issues with temperatures to help them understand that these issues, although worse – are not new. I hope that the same people that are outraged knowing that patients are without their life-saving medications don’t stop fighting for safe and prompt access to medications when the issues with USPS resolves.

When I signed up for insurance for my son, a transplant patient, I didn’t sign him up to be FORCED to risk his life with the many issues with mail-order pharmacy and neither did these patients or veterans.  My advocacy started for him due to the temperatures that risked my child's life, but quickly,  our supporters, patients, and pharmacists informed me about the delays.

This week, I am going to be posting images with statements about mail-order pharmacy underneath any representative or possible influential person that I can find. Feel free to copy them. I’m going to tell patients to file complaints with the State Boards of Pharmacy when their medications don’t arrive. Although, I expect for Boards to do little from my own experience with them; maybe, we'll apply pressure and someone as passionate as I am will help us save lives and increase accountability.

If you know of anyone with a platform who would be willing to help, please let me know. 

I want to win safe access to medications for all patients and for our children. As much as I hate to see the delays of medications by USPS, this is the time to apply pressure!  

Thank you to all of our supporters and to anyone helping to raise awareness about these issues.

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Share your story:  loretta@uniteforsafemeds.com