Retail versus Mail Order Prescriptions

The cost of prescription drugs is on the rise every year. With insurance benefits proving to be more costly to employers, companies are finding ways to cut costs. One-way is increasing the amount the employee pays out of pocket (in both co-pays and deduction from paychecks). The other is requiring employees to use mail order pharmacy services rather than the tradition retail pharmacy services. General Motors Corporation saved $80 million in 2005 by making mail-order pharmacy mandatory. It is a move that companies large and small are leaning towards, and most employees will be affected.

What It Costs:

A retail pharmacy deals with every level of prescriptions; this includes emergency, compounds and maintenance medications. By trade, retail pharmacy has produced some great profits. Companies like Walgreen's, CVS, Rite-Aid and Brooks are considered the "Big Four" of pharmacies. CVS operates the largest number of stores in the United States, expanding down south and west to California. Walgreen's does the highest volume of prescriptions in the United States. It has consistently ranked number one in customer satisfaction for the past five years.

A Pharmacy Benefits Managers typically runs a mail order pharmacy. Companies that are PBMs include Medco and Aetna. Though run by the specific insurance company, certain aspects are outsourced to other companies. These mail order pharmacies are for maintenance medications, also known as "chronic conditions" such as high cholesterol, high blood pressure and diabetes. They are not for emergency medications, such as an emergency room visit resulting in pain medications for a broken bone or antibiotics your child may receive a prescription for an ear infection or strep throat.

Most insurance plans allow two fills of a maintenance medication per year at a retail pharmacy for a 30-day supply. After this, you must set up a mail order account through your respected insurance company. Normally, a letter when enrolling in a certain prescription plan will explain this to you.

There are many money saving advantages using mail order: