The debate rages over which option provides the better experience: pharmacy filled-and-delivered prescription drugs, or mail-order systems. Generally, research has shown that more patients prefer to get their drugs through a retail pharmacy than by mail.
However, when it comes to who's saving who more money, two new studies suggest that mail order wins that one hands down.
The thumbs up for mail order come from two analyses: One by Centers for Medicare & Medicaid Services, another by Kaiser Permanente and the Centers for Disease Control and Prevention.
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The former analysis compares mail-service pharmacies and retail pharmacies in Medicare Part D claims, while the latter looks specifically at the experiences of patients with diabetes.
The Medicare Part D "finds that mail-service pharmacies have lower overall costs," reported the Pharmaceutical Care Management Association.
"CMS' data confirms what consumers have known for years: mail-service pharmacies offer a better deal than drugstores in Medicare Part D. This is unwelcome news for drugstore lobbyists who want new regulations on their more affordable competitors," said PCMA President and CEO Mark Merritt.
CMS looked at 57 plan sponsors with prescription drug plans that included the option of mail-order delivery. In analyzing claims data for the top 25 brand and top 25 generic drugs that can be obtained through either mail order or retail pharmacies, CMS found that mail-service pharmacies cost 16 percent less than retail pharmacies.
When CMS looked at generic drugs only, the cost advantage via mail order was 13 percent compared to pharmacy prices.
The PCMA claimed that CMS's summary report " fails to note the central point: mail-service pharmacies typically charge much lower drug prices than drugstores," thus referring to the ongoing who's-better battle between mail order and retail.
"This is reminiscent of an April CMS study … that downplayed its conclusion that the vast majority of preferred drugstores charge lower drug prices than non-preferred drugstores," PCMA said.
The Kaiser Permanente study crunched data from diabetes patients who get their heart drugs via mail.
In that study, funded by the Centers for Disease Control and Prevention, the conclusion was that those patients made fewer trips to the emergency room than those who picked up their meds at the pharmacy window. This is a different sort of cost savings than drug-by-drug comparisons such as CMS's. Many studies have shown the cost effectiveness of limiting patient visits to emergency rooms; savings are potentially in the billions of dollars for systems that accomplish this.
The study was the first to look at the potential impact of mail order pharmacy on patient safety and utilization, according to study authors. The study didn't offer possible reasons why mail-order pharmacies were associated with fewer emergency room visits.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
