PBM's Fail Employers with Mail

Implications:
Mail did not produce higher generic utilization rates or lower costs for employers who hired a PBM to accomplish both.


Analysis: For the last decade PBM's have actively engaged employers to move maintenance drugs to mail ostensibly for the lower costs available via that channel.

Yet a study published in The Journal of Managed Care Pharmacy reveals mail relative to community pharmacy;


Generated lower generic utilization rates (37.7% Mail versus 49% Community Pharmacy);
Produced higher costs in roughly half the top 20 generic categories;
Plan sponsors were found to make higher payments per day of drug therapy for prescriptions dispensed via mail order for many therapeutic categories.
One plan sponsor paid higher net costs for generic drugs secured through mail

This study was conducted from claims data from two public entities in Texas covering over 637,000 members and 8.7M pharmacy claims. In other words it is we taxpayers in The State of Texas who get to pay for "failed mail". I call it failed mail simply because implementing a process that moves members who desire the low cost in therapuetic class generics could easily take the overall generic utilization rate at least to 49% and likely into the 70% range for some employers.

Assuming mail order is less costly may prove to be an expensive mistake.