Study Suggests Seniors Oppose Restrictions on Their Freedom to Use the Pharmacy of Their Choice

Seniors have medication needs that cannot sufficiently be met by mail service pharmacy, a recent study in the Journal of Managed Care Pharmacy suggests.

Medicare-eligible senior citizens may be the population most affected by the loss of local, community pharmacies, according to a new study assessing the attitudes of these adults on the implications of requiring mail order pharmacy in prescription benefit plans.

Lead author Michael T. Rupp, PhD, BPharm, FAPhA, used responses to patient surveys to determine how consumers view mandatory mail order provisions of prescription drug benefit programs. Specifically, he examined Medicare-eligible participants aged 65 and older both in rural and nonrural environments and questioned them about the cost, convenience, reliability, security, confidentiality, and economic viability of mail order pharmacy services. Rupp also inquired about how medication storage conditions were addressed by mail order companies, as well as pharmacist accessibility to participants through the mail order system.

Of 669 completed surveys, nearly 60% of respondents agreed that they would be concerned about getting their medications when they needed them if they used mail order pharmacy. If they did use a mail order pharmacy, nearly 63% agreed they would be concerned about losing the freedom to use the pharmacy of their choice. In addition, nearly 56% agreed that they would be concerned about not having access to a pharmacist who knows them and the medications they are prescribed.

Notably, when asked if they would object to mandated mail order if it would cause their local community pharmacy to close, 533 respondents (nearly 84%) said “yes.” In addition, the majority (nearly 72%) of respondent comments expressed a negative attitude about mail order pharmacy, and the most frequently expressed concern was the existence of any mandate that would limit seniors’ right to use a pharmacy of their choice.

Rupp concluded that seniors are aware of the limitations of mail order pharmacy, and seniors living in rural areas are particularly worried about their medications being lost or stolen, not getting the exact medication the physician prescribed, and the effects of exposure to heat, cold, or moisture on their drugs.

According to Rupp, “Research has challenged the cost advantages of mail order to plan sponsors, and concerns have been raised about the implications of mandating mail order in prescription benefit plans.” Although nearly 52% of subjects agreed or strongly agreed that using a mail order pharmacy is less expensive than using a local pharmacy, only around 12% of respondents said they are currently required to use mandated pharmacies, whereas nearly 57% said they have used mail order for prescriptions in the past.

“Beyond their specific concerns about mail service pharmacy, most seniors appear to oppose any restrictions on their freedom to use the pharmacy of their choice as a matter of general principle,” Rupp concluded. “Even among those who are generally satisfied with mail service pharmacy, seniors are relatively risk averse when it comes to the loss of their local community pharmacy.”

This issue may be especially relevant in the case of specialty drugs, as many payers have recently begun mandating the use of specific pharmacies for specialty medications in order to cut costs. In addition, because of the specialized handling of many specialty medications, waste associated with improperly stored medications could be particularly expensive.