Pa. pharmacists fight mail-order mandates

Pharmacists in Pennsylvania are battling against mail-order drug companies this legislative session. They are pushing for a bill in Harrisburg that would prevent insurance companies from requiring patients to get some of their prescription drugs filled via mail order.

Pharmacists say customers should have a choice about where they fill their long-term prescriptions, such as medications for high blood pressure.

Robert Frankil, who owns pharmacies in Bucks and Montgomery counties, said mail-order companies have been siphoning patients away from businesses like his for years.

“We can’t survive on just filling your antibiotics that you need right away,” Frankil said. “If we fall by the wayside one by one, when someone really needs pharmaceutical care, they’re going to have much fewer choices to go to.”

Frankil argued that mandating mail orders doesn’t give patients a chance to ask questions about drug interactions or anything else face-to-face, which is especially important for elderly patients and those on multiple medications.

According to Adam Fein, an industry consultant in Philadelphia, about one in six employers have mail-order mandates for the “maintenance” drugs. The rest offer incentives, commonly allowing customers to pay one co-pay for a three-month supply of drugs rather than three. To Fein, these incentives, which the bill would also ban, make sense.

“It’s not you or I reaching into our pocket to pay for the drugs, we’re asking someone else to pay for us, a third party, our employer usually, or the government.” Fein said.  “It seems to me that that payer should have a right to make you the consumer get that drug the most cost-effective way possible.”

Pharmacists said they can compete on price by offering more generics.

Almost identical bills have been introduced in the legislature before. Proponents said this year they have more industry support and are optimistic about their chances with the new administration.

In April, Frankil and other pharmacists will lobby in Harrisburg for the proposed legislation.