NCPA study finds 90-day scripts at retail delivered at lower cost than mail-order

ALEXANDRIA, Va. — A newly conducted study of millions of Medicare Part D prescription drug event data has found that community pharmacies provide 90-day medication supplies at lower cost than mail-order pharmacies and that local pharmacists substitute lower-cost generic drugs more often when compared with mail-order pharmacies.

With funding from the National Community Pharmacists Association, Norman Carroll, professor at Virginia Commonwealth University, reviewed PDE records for 2010 that were supplied by the U.S. Centers for Medicare & Medicaid Services. The analysis found that for 90-day prescriptions filled by local pharmacies, costs per unit of medication, as compared with mail-order pharmacies, were lower for total costs ($0.94 vs. $0.96), Medicare costs ($0.59 vs. $0.63) and all third-party payer costs ($0.64 vs. $0.72). Because of co-pay differentials set by health plans to incentivize mail-order usage, patient costs at retail were higher for patients ($0.31 vs. $0.24 at mail order) even though the total cost of those prescriptions was less at retail, Carroll noted. 

Local pharmacies also substituted generic medicines more often than mail order — 91.4% of the time vs. 88.8% at mail order. 

"Local community pharmacists not only offer expert medication counseling face-to-face, but they also provide affordable access to prescription drugs and are leading the way in the appropriate use of lower-cost generic drugs," stated NCPA CEO Douglas Hoey. "This study blows a huge hole in the PBMs' arguments that more mail order is the right prescription for Medicare Part D savings."

With the release of the study, NCPA is advocating that local pharmacies be allowed to fill 90-day prescriptions. According to the association, Medicare Part D drug plans are only required to have some retail pharmacies in their networks provide 90-day supplies. Those plans that rely solely on mail order for 90-day supplies may very well be overpaying for prescription drugs both in terms of total costs and foregone generic drug savings," Hoey said. 

NCPA also suggested that separate co-pay tiers that incentivize use of mail order be eliminated. 

"[Finally], support patient choice and access to local pharmacies," Hoey said. "They offer additional health services like immunizations and make vital contributions to local jobs and tax revenue."