Study to Evaluate the Use of Mail Service Pharmacies

摘要

The report resulted from the congressional mandate in the Medicare Catastrophic Coverage Act of 1988 (MCAA) 'to evaluate the potential to use mail service pharmacies to reduce costs to the Medicare program' (section 202(k)(1)(B) of MCCA). The study was based on data from the literature and from a mail questionnaire and follow-up visits to a sample of mail service pharmacies (MSPs). Study conclusions include: for MSPs in the survey (representing over 75% of the industry in dollar or prescription volume) averages were: $42.32 charge per 76.6 days prescription supply, or $.561 charge per day. Comparison averages from the literature for community pharmacies were: $15.19 charge per 26-day supply, or $.584 per day. The greater charge and fill length for MSPs reflects the predominance of 90-day maintenance drugs among MSP orders; and MSP characteristics indicated they may operate with greater efficiency than community pharmacies. Most MSP customers were part of group contracts with employers or insurers. Typical reimbursement formulas were average wholesale price less a percentage discount, plus a dispensing fee. Because participation in the study was voluntary, most firms were unwilling to provide specific data on the percentage discount amounts.