HealthJune 27, 2023

How pharmacists can prepare for the future of the mail-order pharmacy

For patients and pharmacists alike, the future of mail-order prescriptions holds significant promise — and uncertainty.

While patients are generally enthusiastic about the convenience and cost savings that mail-order pharmacies offer, questions persist around safety and integration with a holistic care experience.

The second installment of Wolters Kluwer’s Pharmacy Next Consumer Survey sheds light on these patient perceptions and many others, underscoring both the growing popularity of and ambivalence toward mail-order prescriptions. Here are key takeaways from the survey and insights for how pharmacists and health leaders can leverage their experience and support as they adapt to this shift toward the future of pharmacy.

What’s powering the shift to mail-order pharmacies?

As costs for healthcare and insurance continue to rise, patients are increasingly considering accessing care and prescription drugs outside of their traditional systems . In many cases, the following systemic factors are driving patients to mail-order pharmacies and giving pharmacists an opportunity to leverage new ways of engaging patients.

Disruption in healthcare relationships

Patients are rethinking how they access care altogether, moving away from primary care models. In fact, 58% of survey respondents indicated they’re likely to visit a local pharmacy first when dealing with a non-emergent medical issue.

They’re also rethinking how they engage with medication access itself. Patients are increasingly open to alternatives to traditional medication access like mail-order prescriptions: Three out of four Americans are likely to get medication from someone other than their physician.

As we saw  in last year’s survey, primary care decentralization is continuing. The traditional one doctor-one patient, single point of coordination is vanishing, and this is especially evident in younger generations.
Dr. Peter Bonis, Chief Medical Officer, Wolters Kluwer Health

Rising healthcare costs

Cost is a primary driver in the shift toward mail-order prescriptions. Nearly two out of three patients report that they’ve seen the prices of their medication increase over the past few years, with one out of three saying costs have increased 6-10%.

More than one third of Americans have skipped filling a prescription in the last few years because of the cost burden. The numbers are even more severe for the uninsured: More than half of patients without insurance skip medications, compared to 42% of those with insurance.

A staggering 67% of survey respondents indicated that they would prefer prescriptions via mail or a subscription service if it meant they could cut costs.

Insurance incentives

Patients aren’t making this shift on their own. Health insurers are also key drivers, as they incentivize patient displacement toward new modes of accessing medication.

Two out of five Americans report that their insurance allows them to access alternative sources for medications. And some insurers have no choice but to offer these benefits. In Idaho, for example, pharmacists faced the prospect of losing hundreds of customers after Kaiser Permanente shifted exclusively to mail-order medication fulfillment.

How pharmacy leaders can support medication access transformation

As patients continue to adapt to a decentralizing healthcare landscape, pharmacy leaders have growing opportunity to help them navigate new options in medication access, while supporting better care for all pharmaceutical consumers.

Turn ongoing safety concerns into opportunities for education

Patients are motivated by costs, but they also have legitimate concerns about safety — and pharmacists are well-positioned to guide their decisions.

Stories like the death of Bertha Autry Small, whose family sued a mail-order service in 2019 for sending the wrong medication linger in the mail-order pharmacy conversation. At the same time, stories of neglectful deliveries of temperature-sensitive medication, crushed pills, and damaged vials have been reported by mainstream news. Cybersecurity is even a concern amid recent reports of a mail-order pharmacy “improperly” sharing patient data with an affiliated business.

Many Americans are worried about safety issues around mail-order prescriptions, with three out of five fearing that their medication could be tampered with or possibly stolen before it reaches them. Consumers have other safety concerns around mail and subscription services, as well:

  • 66% fear prescriptions will get lost or delayed.
  • 54% worry about tampering.
  • 52% are concerned about potential interactions.
  • 50% are worried that their medications won’t be as safe and effective as intended.

Some patients are even taking on the burden of paying out of pocket to maintain the safety and familiarity benefits of getting medication from someone local who knows their medical history.

To ease these concerns, agencies like the US Federal Drug Administration (FDA) have stepped in to provide patient-support resources — such as reporting tools, connections to state pharmacy boards, and tips for buying online — that can steer concerned consumers away from higher-risk pharmacies.

The FDA has also issued letters about “rogue online pharmacies” — entities that have engaged in illegal activity, including offering prescription drugs without a prescription, selling unapproved drugs, and providing prescription drugs without directions for safe use or FDA-required warnings.

Pharmacy professionals are well-prepared to address these challenges. More than half of patients believe their pharmacist checks their medical records before filling a prescription all or most of the time. Because of this consumer trust, pharmacists have an opportunity to guide patients in understanding safety requirements and help them find their best and safest options in mail-order pharmacies.

Help patients adapt to a changing landscape of new and complex options

Pharmacists can help reduce variability in care by leveraging their history as trusted providers, even as prescription fulfillment options grow.

The decentralization of US healthcare means patients are being directly approached by an influx of new entrants, including services like Cost Plus Drugs and Express Scripts and familiar brands like Amazon and CVS. Patients are navigating new concerns, such as how the ways their medication is being shipped and stored could impact efficacy. A study of patients with hypothyroidism found that 1% of hypothyroid and 5% of those with refractory hypothyroidism could trace their issues to improper storage of tablets.

Because more than three out of four Americans surveyed trust non-physician clinicians to advise on medications, pharmacists have an opportunity to help patients navigate unfamiliar territory.

Pharmacists can direct patients to resources like the FDA’s guidance on how to safely buy from online pharmacies. They can also help patients understand online and mail-order licensing requirements when looking for reliable alternatives to traditional pharmacy relationships. They can help raise awareness of the importance of choosing options that maintain proper storage standards, possibly even serving as a checkpoint for patients who are unsure of their decisions.

Lead the cost conversation amid strained patient finances

Pharmacists are in the perfect position to talk with their patients about options in navigating increasing drug costs, such as biosimilar solutions that are potentially cheaper alternatives to insulin for diabetes patients. And patients are open to this type of conversation. According to the survey, more than a third of Americans have talked with their pharmacist about medication affordability and finding other options in the previous few months.

Pharmacists who keep up with shifts in mail-order options, challenges, and benefits will be well-prepared to help patients balance cost-driven decisions that also maintain safety and efficacy.

Take action to turn obstacles into opportunities

As the future of pharmacy and medication access continues to become more complex, pharmacy professionals and leaders will see increasing benefits from understanding consumer attitudes and behavior around new delivery methods.

To keep pace with these shifts toward more convenient and cost-conscious care, explore available resources on Pharmacy Next and download the consumer survey executive brief and infographic.

Download The Executive Brief
Download The Infographic
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