Has anybody seen the fifth guy?

WHAT IT MEANS AND WHY IT'S IMPORTANT — If you were to tell me that 4-out-of-every-5 people would choose 90-day prescriptions available by pickup at the pharmacy versus 90-day prescriptions delivered through mail order — and for about the same cost — I would tell you that we need to find the fifth person and make sure that they're OK. They might be suffering from a medical emergency and could need our help. The publication of this study in a peer-reviewed journal, however, serves as proof of concept addressing two concerns — choice and plan cost. In other words, giving patients choice of 90-day at retail doesn't have a material impact on plan cost.

(THE NEWS: Walgreens study finds patients prefer to fill Rxs at community pharmacies. For the full story, click here.)

That cost-neutral aspect is an important distinction to make, given what's happening in the marketplace — namely the Express Scripts-Medco merger, and at an important time, during the PBM selling season. The fact is that a lot of the healthcare debate today really comes down to that one critical consideration — how much is this going to cost at the end of the day? If "this" is 90-day at retail and the answer is, "Not any more than mail order," then increasing patient choice by including 90-day at retail becomes an easy choice to make for health plan administrators.

Because the four patients that do go to the pharmacy have a living, breathing pharmacist who can counsel them on their medications when they come in; they have a pharmacist who, with multiple intercept opportunities, can help improve medication adherence and compliance through any number of programs; and they have a retail pharmacy operator that is engaging them online, through their emails and on their smartphones, or just about any venue that those 4-in-5 patients choose. And, chances are, those 4-in-5 patients who avail themselves of that kind of personal attentional from their pharmacist don't find themselves in a medical emergency nearly as often.

So 90-day at retail is cost-neutral and helps increase compliance through better choice. That leaves just one question left for health plan coordinators: Has anybody seen the fifth guy?