Mail-order prescriptions can be a convenient, safe way to receive the medications you need to stay on track without skipping a beat. Not to mention, using these services may help reduce your exposure to COVID-19, because you won’t need to leave home to obtain them. Here’s what you need to know about getting started with mail-order Rx and how these services may benefit you. Some people think these services are one and the same. Online pharmacies, however, are typically online stores for a brick-and-mortar pharmacy. Mail-order pharmacies are unique because they work through entities known as pharmacy benefit managers (PBMs) and partner with insurance companies to pay for medications, explains Chirag Shah, MD, the cofounder of Push Health, a telehealth marketplace based in El Segundo, California. Filling or refilling a mail-order prescription with a mail-order pharmacy requires one type of insurance. Online pharmacies, on the other hand, work with different insurance companies, in which case they may or may not accept your insurance, according to GoodRx, a website that tracks prescription drug prices and offers free drug coupons. Mail-order prescriptions can provide some peace of mind, because they allow you to get the meds you need without leaving the safety of your home. But this isn’t the only reason to consider the service. If you’re using a mail-order pharmacy, some drugs may be available in larger quantities for added convenience, notes Express Scripts, a prescription benefits plan provider. So instead of a 30-day supply, you might receive a 90-day supply. This way, you won’t need to refill your prescriptions as often. In some cases, mail-order prescriptions are also more affordable, says Dr. Shah. (More on this later.) Mail-order pharmacies may offer benefits for health condition management, research suggests. When the authors of a review published in November 2016 in the Journal of Managed Care & Specialty Pharmacy analyzed 15 studies, 14 of them suggested that mail-order pharmacy use was associated with better adherence to medication. But researchers noted that these participants tended to have high adherence rates before switching to mail order, and they tended to have a higher socioeconomic status, the authors wrote. More studies are needed. There are certainly some potential benefits to using mail-order prescriptions, but also consider that this type of service may not be right for you. “Mail-order prescription services are mostly intended for patients who require regular daily doses, also known as maintenance medications, to keep them on a regular schedule and minimize the risk for lapse of treatment,” says J. Bradley Nelson, PharmD, the manager of clinical services at RxBenefits, a technology-enabled pharmacy benefits optimizer based in Birmingham, Alabama. “Examples [of maintenance medications] include medications for blood pressure, asthma, heart disease, and diabetes,” Dr. Nelson says. “Conversely, one-time prescriptions, such as antibiotics to fight off an infection, aren’t medications to be considered for mail order.” During the COVID-19 pandemic, you may be able to get these one-time medications via free mail delivery from your retail pharmacy. “Prescription insurance will typically cover medication procurement through mail-order programs, even if you don’t live in the state where the pharmacy is located,” says Nelson. “The pharmacy, however, must be licensed as a mail-order pharmacy by the resident state of the patient to perform this function,” he warns. Nelson notes several versions of mail-order programs. Sometimes, patients can opt to participate in prescriptions by mail. Other times, program participation is mandatory, meaning patients are required to receive certain prescriptions by mail, such as maintenance medications taken on a regular basis for blood pressure, cholesterol, and diabetes management, he says. For example, if you have Aetna as your health insurance provider, you’ll have your prescriptions filled and delivered from CVS Caremark Mail Order Pharmacy. To start using a mail-order prescription service, call the number on the back of your health insurance ID card and request a prescription mail-order form, or download the form via your insurance provider’s website. You’ll then mail your prescription and the order form to the mail-order pharmacy. Or, ask your doctor to send your prescription electronically to the mail-order pharmacy, according to GoodRx. The time it takes to receive a mail-order prescription varies, and depends on whether it’s a new medication or a refill for an existing medication, says Nelson. “New medications may take 7 to 10 days to arrive after the prescription is received from the provider. Also, shipping times might be delayed if the insurance plan requires additional information prior to covering a specific medication.” The fact that it can take up to 10 days is another reason why mail-order prescriptions aren’t suitable for a one-time prescription that you might need immediately, like an antibiotic. It’s important to note that if you need a maintenance medication immediately, often a “grace” fill for a short-term supply (typically 30 days) at a local retail pharmacy is allowed for new prescriptions, until the mail-order process has kicked in, explains Nelson. Above all, you don’t want to skip any medication doses, so you can keep your disease management on track. For example, a study in the Journal of Managed Care Pharmacy comparing costs associated with a 90-day prescription supply at retail and community pharmacies and mail-order pharmacies found that allowed charges per claim weren’t significantly different, with community pharmacies being only slightly cheaper. Further research is needed. Why are mail-order drugs sometimes cheaper, though? “Some mail-order pharmacies are focused on utilizing generic medications and cash pricing, which lowers the cost of the medications,” explains Shah. He says some mail-order pharmacies can buy directly from manufacturers to lower the cost of their drugs, and they often have lower overhead costs, as they’re not using retail locations as delivery points. Drug prices vary considerably depending on which mail-order pharmacy you use. Of course, the medication you’re taking will also factor in. For example, you can receive a 90-day supply of a generic medication for conditions like blood pressure, diabetes, and mental health conditions starting as low as $10, according to data provided from Walmart’s mail-order prescription program. For other conditions, a 90-day supply can range from $24 to $38. With CVS’s Caremark mail-order pharmacy, you might only pay $7 and $14 for a 30-day and 90-day supply of a generic medication, respectively. On the other hand, Express Script’s mail-order pharmacy offers 90-day supplies of certain generic medications starting at only $9. Yes, you can. Instead of using a mail-order pharmacy, you’ll need to use a local retail pharmacy that offers home delivery, or an online pharmacy that operates like an online drugstore. Just make sure that the chosen pharmacy accepts your insurance before you place your order.
How Online Pharmacies Work and What You Must Know About Them
Online pharmacies are internet-based pharmacies that sell medications. They offer convenience, and some may offer better prices on medications than retail stores, according to an article published in the November–December 2016 issue of the Indian Journal of Pharmacology. Also, some accept health insurance, savings cards, and coupons. For example, PillPack works with most insurance plans and accepts most manufacturers’ coupons, according to its website. Honeybee, on the other hand, doesn’t take insurance, but offers prescriptions at wholesale prices to keep them affordable. These are just two examples of online pharmacies. But even though there are legitimate companies, online pharmacies aren’t without risks. Less-reputable pharmacies may fill a medication without a prescription, or sell medication that’s outdated, diluted, or fake, according to the NHS. Some people are also attracted to overseas pharmacies because of their cheap prices, yet these pharmacies are hard to regulate, warns GoodRx, so you might also receive a medication that’s fake or outdated. According to the U.S Food and Drug Administration (FDA), you should only order from websites that require a prescription, and only use pharmacies that are licensed in the United States. GoodRx also advises checking the National Association of Boards of Pharmacy’s (NABP) website to see if an online pharmacy has the proper license. According to a study presented virtually during the 2020 American Society for Health-System Pharmacists (ASHP) Midyear Clinical Meeting and Exhibition, improper storage can reduce the effectiveness of some prescription drugs delivered via mail, putting patients at risk. Most medications require storage at room temperature — typically between 68 and 77 degrees F. Unfortunately, exposure to temperatures above or below these degrees can alter a medication either physically or chemically, researchers note. For the study, 48 nonrefrigerated prescription drug packages were shipped to six different locations using the United States Postal Service four times in the summer and four times in the winter. Each package contained a temperature data logger, and based on the logged information, researchers found that every shipment had been exposed to inappropriate temperatures at some point during transit. As a customer you can’t always tell whether a medication received via mail has been altered or exposed to unsafe temperatures. A few signs indicating both include a change in color, shape, or texture, warns the Arthritis Foundation. If you’re concerned about this risk, talk to your healthcare team. And remember: You can have your prescriptions filled through your local pharmacy. Some local pharmacies may offer quick shipping or courier services. In that case, the risks of prolonged, potentially risky temperature exposure are minimized. Many retail and online pharmacies charge standard shipping fees. But some pharmacies have temporarily waived their delivery fee because of COVID-19, according to an AARP news report. Visit your usual pharmacy website to find out if they have waived their fees. For eligible prescriptions, CVS and Walgreens are among the retailers that have suspended these fees during COVID-19.
A Final Word on Getting Prescription Medication Delivered to Your Home
Depending on your insurance coverage, medication, and the service you choose, these services may be a convenient option for you now and beyond COVID-19. Talk to your healthcare team about the right approach for your health condition.
