Mail Delays Could Affect Mail-Order Prescriptions for Millions of Medicare Part D Plans

In July, the new Postmaster General instituted changes in the operation of the U.S. Postal Service that could result in delays in mail delivery. More recently, the post office has suspended these changes until after the November election. Prior to the announcement that he was postponing these changes, the Postmaster General had warned states of the possibility that mail-in ballots requested close to state deadlines would not be received in time to be counted in November’s election. Changes to the Postal Service’s delivery standards have potential implications that extend beyond those for the election.

Potential mail service delays could also be a concern for people who receive prescription drugs from mail-order pharmacies. In 2019, sales of mail-order prescriptions in the U.S. totaled nearly $145 billion (excluding rebates), with residents of some states more likely than others to use mail-order pharmacies. Mail service delays could affect a relatively large number of people in the midst of the COVID-19 pandemic. Data from the first seven months of 2020 shows that use of mail order increased by up to 20% over 2019 levels in the early weeks of the pandemic as patients stocked up on prescriptions and avoided retail settings, but as of late July, mail-order use is up only slightly compared to the same period last year. Getting prescriptions through mail-order pharmacies can offer convenience and cost savings to patients. Many large group plan enrollees choose to fill prescriptions at reduced cost through the mail, while others are only able to fill scripts at a mail-order pharmacy.

To understand who may be most affected by delays in the delivery of prescription drugs, we analyzed use of mail order in Medicare Part D and large group employer plans, and identified the therapeutic classes and specific drugs with the highest volume of fills by mail-order pharmacies in each market.

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