Maintenance medication options

True or false. All maintenance medications should be filled through a mail order pharmacy. Answer: True, if you own a mail order pharmacy.

The pressure to fill more and more prescriptions through mail order pharmacies has been driven by PBMs who need to show a return on their large investment in these types of dispensaries. A close analysis reveals a number of facts that contradict this type of approach:

1. Generic prices tend to be inflated at mail order pharmacies, often much higher than what would be paid for the same drug at a retail pharmacy
2. Improperly designed co-pay structures actually cost plan sponsors more money than if the same prescription were to be filled at a retail pharmacy
3. There is a willingness at retail pharmacies to offer deeper discounts for extended days supply prescriptions for maintenance medications

Every prescription program should have a mail order option, but it is critical that the design of your clients' plans meets their goals and not just the goals of your PBM.