Why the Rise in Mail-Order Pharmacies Is Important for Patients

Having prescription medications delivered right to a patient’s door has never been easier. Patients now have more options than just driving to the pharmacy, standing in line, and waiting to pick up chronic medications. 

Mail-order pharmacies provide the convenience of having medications sent directly to patients. They can also have a positive impact on health outcomes by increasing patients’ medication adherence. The World Health Organization found that medication adherence can have a greater impact on health than a specific treatment, as increased medication adherence leads to reduced hospitalization, costs, and mortality rates.

Let’s look at the many benefits and challenges for patients from mail-order pharmacies, and how pharmacists can help patients understand whether mail order is a good option for them.

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Medication adherence improves with mail-order pharmacies

Patients are considered adherent if they take 80% of their prescribed medications. However, only 50% to 60% of patients with chronic conditions report adhering to their prescribed medications. Can mail-order pharmacies be a key factor in helping to address barriers to medication adherence? 

Kaiser Permanente conducted two separate studies to see if using mail-order pharmacies was associated with increased medication adherence. Both studies in stroke and diabetic patients who received their medications through mail-order pharmacies showed improved medication adherence, compared with those who received their medication refills from a local pharmacy. 

In the study for patients with diabetes, Kaiser found that using a mail-order pharmacy was associated with an increased adherence of 7 to 8 percentage points. However, the use of mail-order pharmacies remains low. The Medical Expenditure Panel Survey found that the prevalence of mail-order prescriptions between 1996 to 2018 was only 9.8% in adults, though the numbers have trended up over the years. 

So if a mail-order pharmacy is not only convenient but also helps increase medication adherence, why aren’t more patients using it? Let’s discuss the benefits of and the barriers to using mail-order pharmacies and how these affect medication adherence.

The benefits of mail-order pharmacies

These include:

• 24/7 pharmacist consultation

• Convenience

• Cost savings on transportation

• Increased medication adherence

• Larger medication supply (3 months)

• Lower copayments

• Reduced potential exposure to illness, such as the flu, cold, or COVID-19

• Significant time savings waiting for medications

A systematic review of studies showed that patients who use mail-order pharmacies are more adherent to their medications. Convenience is, of course, a big factor: Mail-order pharmacies remove the hassle of having to make a trip to the pharmacy to pick up medications. When medications are delivered right to patients’ doors, and they receive a larger supply of their medications, there is a lower chance of having gaps in their treatment. Using a mail-order pharmacy also helps to save on costs such as transportation. 

For patients who do not have reliable modes of transportation, getting medications delivered helps improve access to their medications. Many health plans also provide incentives to use mail-order pharmacies, such as lower copayments or larger supplies of medications dispensed. 

The barriers to mail-order pharmacies

Some of the issues patients have with using mail-order mail-order pharmacies are:

• Concerns about compromised safety and efficacy of medications

• Costs

• Delivery time

• Health literacy

• Lack of face-to-face pharmacist consultation

• Mailbox security concerns

• Navigating the ordering system

A national survey conducted by Public Policy Polling found that 85% of 1,390 adults still prefer to get their prescription medications from a local pharmacy, compared with a mail-order pharmacy for the reasons listed above. 

Pharmacists play a role in keeping patients informed

Pharmacists can address barriers by informing patients of all the benefits of mail-order pharmacies — from touting the convenience of mail-order pharmacies to their cost savings. Pharmacists can also provide an overview of how to navigate through the mail-order system, reassuring patients that there is pharmacist support available 24/7. 

In helping to educate patients about these issues, pharmacists can play a direct role in increasing the use of mail-order pharmacies, reducing costs for patients and improving health outcomes and patient satisfaction.

But even though pharmacists can help grow the number of patients using mail-order pharmacies by educating them about their benefits, many pharmacists in retail and community pharmacies may not actively promote mail-order pharmacies for several reasons: When more patients use mail-order pharmacies, this can adversely impact the prescription volume in their stores. The retail pharmacy setting also tends to be fast-paced and busy, which can mean that there’s less time for a pharmacist to provide patients with information on mail-order options. 

It’s true that the mail-order pharmacy option may not work for everyone. However, it can be beneficial for patients who do not have reliable modes of transportation or who forget to request their prescription refills on time. These patients can easily be identified by looking at their refill histories, for example.