Remember When: Mail-order pharmacy appeared to be losing momentum

On July 20, 1992, a Drug Topics cover story posed the question, “Is Mail Order bombing?”

That story outlined the controversy mail-order pharmacy had created, including reports of medication mix-ups endangering or killing patients, and alleged unfair practices by insurance companies and pharmacy benefit managers.

A separate story in that same issue was titled, “Rite Aid takes on mail order in Maine.” It reported that Rite Aid had acquired 27 Wellby Super Drug Stores in Maine and immediately pulled those employees out of an insurance plan that forced them to fill prescriptions through the mail.

Not the smoothest of starts

Both stories suggested mail-order pharmacy had not lived up to its billing. “It was a fad that hasn’t worked. Many of those who bought into mail order have found their costs continuing to rise,” Robert Johnson, then CEO of PCS Inc., told Drug Topics.

Many pharmacists clearly hoped that mail order-and the threat it posed to brick-and-mortar pharmacies-would dissipate. Others called that wishful thinking. “It’s good PR for competitors to say we’re not growing,” Dell Konner of the American Managed Care Pharmacy Association said. “If you repeat something often enough, people start to believe it.”

According to the story, mail-order pharmacy had jumped from $100 million in sales in 1981 to $3 billion in 1991. 

A battle lost?

Mail order has continued to grow, as insurance companies force more and more customers to either use mail-order or pay larger co-pays for maintenance medications. Some states have considered legislation that would give patients the choice to opt-out of mail-order. Those efforts, however, have not slowed the growth of the industry.

According to the Agency for Healthcare Research and Quality, in 2014 45.6% of male patients and 54.4% of female patients filled at least one prescription via mail order. Of those, nearly 79% of the mail orders were from patients with private insurance.

Kaiser Permanente, for example, in 2015 filled 20.6 million prescriptions through mail order. From 2009 through 2014, Kaiser earned J.D. Power’s highest ranking of all mail-order services.

“We know that receiving prescriptions through the mail not only increases our members’ satisfaction, but also improves medication adherence, which promotes their total health,” said Joseph Douglas, a Kaiser Permanente VP.