Personally, I feel that mail-order prescription services have saved my life, so I almost choked on my breakfast bar the other morning reading this Philadelphia Inquirer headliner: "Pharmacists Take On Mail Order."
You. Are. Kidding. Me. Now the powers that be are trying to take away the ability for us to have 90-days' supply of our meds and equipment delivered to our doorstep? Don't they know what a boon that is to people who depend on multiple prescriptions that would otherwise be running out at different times every month, forcing us to virtually live at the pharmacy?!
The premise of angry pharmacists, losing business across the nation, is that "mail-order treats filling a prescription as delivering a commodity — like buying books from Amazon or sheets from Lands' End — not providing an aspect of medical care, and that patients benefit from a consistent relationship with their pharmacist."
Well, it IS a commodity for many people with chronic illness, who need to keep taking the same stuff over and over...
It turns out they're not necessarily trying to ban mail order (impossible even if they wanted to), but rather are fighting for new legislation — Senate Bill 616 and its counterpart, House Bill 838 — that would give traditional pharmacists "the right to offer multi-month prescriptions on a similar basis to those offered by the mail-order houses." OK, fair enough.
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The other argument they make is that people shouldn't be forced by their insurers to use mail order if they do not wish to. Many insurers apparently require it because it's simply cheaper for them. The woman used an example in the Inquirer story complains that packs of her diabetes meds have disappeared from her porch, and she worries that insulin deliveries may get too hot and go bad.
Heck, I wrote about the forced mail-order controversy back in 2005. My take on that is: there's a role for BOTH retail and mail order because pharmacies are still the best way to fill prescriptions needed immediately, and mail order is best suited for "maintenance drugs" that people like us take continuously. And yes, we do need to keep a watchdog's eye on those mail order providers, so they don't try to chintz by doing things like skimping on ice packs for insulin deliveries!
Meanwhile, the pharmacists are kicking up this big fuss about "the lost value associated with face-to-face contact between patients and traditional pharmacists, ... crucial and undervalued players in the nation's health-care system."
They tout the value of a "consistent relationship with a pharmacist ... a trained professional who knows (the patient) and all the drugs they're taking, not just the painkillers or antibiotics prescribed on a short-term basis for acute conditions." They say it's all about "continuity."
I say: if only it were!
I've been going to the same Walgreens for years, and there's always a different pharmacist at the counter. They look me up in the system, but barely seem to be able to locate my insurance info, let alone any history on me and my conditions. A junior clerk at the counter once guffawed at the insulin cartridges I was picking up: "What ARE these?!" she asked. Um, yes, thanks for the expert counsel there.
My D-blogger buddy Ed from Ring the Bolus writes about his adventures in prescription refills: "The pharmacy is freaking huge and feels more like a DMV than a CVS. There were about a dozen people waiting in chairs staring at some screen that apparently tells you when your script is ready for pick up and there are windows of tellers..." Despite all the paperwork Ed brings along, a guy he calls "Evil Pharmacist" tells him: "We can't refill your script, it doesn't exist."
Right, thanks for the personal touch and the continuity!
I know there are people who do like their hometown pharmacists (see the New York Times health blog on this), but I'm betting they are few and far between. The NY Times blogger writes: "Once, my pharmacist circulated a petition warning customers about the dangers of mail-order giants putting people like him out of business."
I guess it's like Wal-Mart vs. the Mom-and-Pop shops of America. All I'm saying is, if you have a chronic illness like diabetes, mail order meds can be a godsend. And I think the warm fuzzy interaction with your local pharmacist is overrated (if not altogether fictionalized).