Mail Order's Big Bite

Article excerpt

Mail-order dispensers are costing community pharmacists time and money, and independent and chain store pharmacists alike expect to lose more of both in the coming year.

Community pharmacists are counseling, catching serious medication errors, and dispensing "tide-over" supplies for a growing number of customers who regularly receive their prescription medications by mail from another state hundreds or more miles away.

Not enough regulation: Jolted by these new competitive and professional pressures, most pharmacists don't think their state boards or national pharmacy organizations are doing enough to ensure that community and mail-order pharmacy practice under the same regulations. Almost all pharmacists believe interstate mail-order pharmacy should be regulated by federal law, and a clear majority favor an outright ban.

These are just some of the major findings from an exclusive Drug Topics poll of more than 900 independent and community pharmacists nationwide on the Drug Topics Council of Pharmacists. Of that number, 647 answered -- for a 68% response rate. Their opinions present a rare, detailed look at mail-order pharmacy's impact at the retail level.

According to the Drug Topics survey, the average community pharmacy is losing 15 prescriptions a week to mail order. Fully 61% of the independents and 31% of the chain pharmacists responding to the survey said the impact of mail-order pharmacy on their business was moderate or severe. A majority of pharmacists expect to lose even more prescriptions to mail order this year (see table, page 43).

A Tennessee chain store pharmacy manager maintained that "you can't really know the number of prescriptions you miss." But a store manager in central Illinois asserted: "If anyone believes that mail order isn't hurting them at all, they aren't talking to their customers." This R.Ph. estimated his store was losing 21 to 30 Rxs a week and added that the number "could be much higher."

A New Yorker, whose store fills 75 to 100 Rxs daily and who judged mail order's impact as slight, admitted it was difficult to determine how many scripts he was losing. "I am aware of maybe a dozen or so people who do me the 'honor' of filling emergency prescriptions," he noted.

The poll found 8% of all community pharmacists indicating that mail order is severely hurting their pharmacy's business. Another 40% described the impact as moderate, while 45% think mail order is only slightly diminishing business. Six percent believe it has no effect at all.

Independent pharmacists bear more of the brunt of mail-order business than chain pharmacists do, both told Drug Topics. Twelve percent of the independents stated mail order is severely hurting their business, versus only 5% of the chain pharmacists.

In the past year, almost half the pharmacists discovered they were losing more Rxs to mail order. Only 1% said mail-order competition was getting less of their Rx business, and 53% said losses were about the same.

Again, more independent pharmacists than their chain colleagues see an erosion of their Rx volume due to mail-order drugs. Fifty five percent of the independents said mail order is costing them Rx volume, versus 38% of the chains. Further, a majority of pharmacists believe they will lose more in 1991.

Those polled named the American Association of Retired Persons (Retired Persons Services Inc.) as the single biggest mail-order competitor. Also cited was the Department of Veterans Affairs (see table, page 45).

Price a factor: One reason for mail order's growing popularity, especially from the patient's point of view, may be price. The majority of pharmacists polled believe mailer-order drug prices are lower than those at their place of employment. Five percent believe mail-order prices are higher, 11% think they are the same, and 23% said they didn't know how prices compared.

More chain pharmacists than independents believe mail order offers substantially lower Rx prices than community stores do. …