In a letter to New York State Senator James Seward, the Federal Trade Commission warns a New York Assembly bill that regulates health plan use of mail order pharmacies would would likely raise prescription prices and reduce access to affordable drugs.
According to the FTC, Assembly Bill 5502-B would limit a health plan's ability to offer favorable treatment to a low cost mail order pharmacy and would undercut pharmacies' incentives to bid aggressively for a health plan's business. This would likely raise prices for health plan prescription drugs and those cost increases could be passed on to patients.
In some cases, the FTC argues, plans may respond to higher costs by reducing the scope of prescription drug coverage, or by eliminating prescription drug coverage entirely.
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"The Federal Trade Commission's comments on the anti-mail-service pharmacy bill make it clear that it would harm consumers by limiting access and raising their prescription drug costs," said Pharmaceutical Care Management Association (PCMA) president and CEO Mark Merritt in a statement. "Governor Cuomo should veto this prescription drug tax on small business. It pads drugstore profits and sticks employers with the tab."
Home delivery is popular with patients because it offers lower cost 90-day prescriptions for long-term, chronic conditions and is more convenient than driving to the drugstore every 30 days. With mail-service pharmacies, patients can get private counseling over the phone from trained pharmacists around the clock. Numerous studies have confirmed the increased savings, safety, and adherence provided by mail-service pharmacies, including:
- The Journal of General Internal Medicine: In a report released last month, the Journal of General Internal Medicine found that patients receiving their prescription medications through a mail-service pharmacy achieved better cholesterol control compared to those who obtained their statin prescriptions from their local pharmacy.
- The Federal Trade Commission (FTC): The FTC concluded in a 2005 report that PBM-owned mail-order pharmacies offer lower prices on prescription drugs than retail pharmacies and are very effective at capitalizing on opportunities to dispense generic medications.
- U.S. Government Accountability Office (GAO): In January 2003, the GAO examined the value provided by PBMs participating in the federal employees' health plan. For prescription drugs dispensed through mail-order pharmacies, the average mail-order price was about 27 percent below the average cash-price paid by consumers for a brand name at a retail pharmacy and 53 percent below the average cash-price paid for generic drugs.
- Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy: Peer-reviewed data found that highly automated mail-service pharmacies dispensed prescriptions with 23 times greater accuracy than retail pharmacies. The mail-service error rate was zero in several of the most critical areas, including dispensing the correct drug, dosage, and dosage form.
- American Journal of Managed Care: Consumers receiving their prescription medications for chronic conditions through a mail-service pharmacy "were more likely to take them as prescribed by their doctors than did patients who obtained them from a local pharmacy." Key findings from the study include:
- Mail-order pharmacy users were more likely than local pharmacy users to have a financial incentive to fill their prescriptions by mail (49.6 percent vs. 23.0 percent), and to live a greater distance away from a local pharmacy (8.0 miles vs. 6.7 miles).
- 84.7 percent of patients who received their medications by mail at least two-thirds of the time stuck to their physician-prescribed regimen, versus 76.9 percent who picked up their medications at "brick and mortar" Kaiser Permanente pharmacies.
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