Mail-Order Meds

Mail-order pharmacies are often touted as a convenient and cheaper alternative to traditional, brick-and-mortar pharmacies. Many health insurance plans, in fact, give favorable treatment to enrollees who choose them, such as charging a single co-pay for a 90-day supply rather than a 30-day supply of a drug. It makes sense, of course, that prices can be kept lower without the costs of maintaining a retail pharmacy, and that some of these savings can be passed on to the customer. But until recently, there was little data on how — if at all — mail-order pharmacies affect the health of their customers.

Now, a study[1] published in the Journal of Medical Economics finds that mail-order pharmacies actually have a beneficial effect in people with Type 2 diabetes[2]. According to an article from earlier this month[3] at Drug Store News, the study of Medicare Part D (prescription-drug benefit) beneficiaries found that among those who chose a mail-order pharmacy, compliance with their doctor’s instructions for taking a new oral diabetes drug was higher than among those who chose a traditional pharmacy. Prescription records were collected and used to create two demographically and medically similar study groups of 1,361 people: one for each pharmacy type. Compliance with instructions for taking a drug was evaluated through a measurement called proportion of days covered (PDC), which simply counts what proportion of days within the study period (in this case, all of the year 2009) a participant could have taken his drug as directed, given how often the prescription was filled. Good adherence was defined as having had enough refills to take the drug at least 80% as often as directed (a PDC of 0.8 or higher).

Members of the mail-order group were found to achieve good adherence at a rate of 49.7%, versus 42.8% for the traditional-pharmacy group. Their average PDC was 0.68, compared with 0.61 for the traditional-pharmacy group — both well short of good adherence, as defined by the study. While these results are persuasive in suggesting a benefit from mail-order pharmacies, because the study simply looked at collected data and was not a randomized trial, it is possible that an unknown factor could have led many participants both to choose a mail-order pharmacy in the first place and to take their drugs as prescribed more often.

The view among people with diabetes on traditional versus mail-order pharmacies is mixed. Here at, blogger Jan Chait wrote a couple of years ago[4] about how her neighborhood pharmacy had helped her — and saved her hide — in ways that a mail-order pharmacy could not. Eric Lagergren, however, wrote in a separate piece[5] about how despite his feelings of loyalty and affection toward his local pharmacist, he would be switching to a mail-order pharmacy because of the convenience it offered — and because of problems with his local pharmacy’s refill service that made multiple trips necessary.

What do you think — have you switched, or are you considering switching, to a mail-order pharmacy? If so, what are/were the factors in your decision? Have you experienced significant problems with either a traditional or a mail-order pharmacy? Are you satisfied with the way your health insurance plan treats traditional and mail-order pharmacies? Leave a comment below!

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  2. Type 2 diabetes:
  3. article from earlier this month:
  4. wrote a couple of years ago:
  5. wrote in a separate piece:

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