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PBM 101: Does Mail Service Pharmacy really save me money?

Mail service pharmacy certainly offers deeper discount for prescriptions, it is not always a given that mail service pharmacy actually saves money. In fact, there has not been one qualified study published that proves mail service pharmacy saves the payor money.

There are at least three reasons that mail service pharmacy might not save you money: 


  • ONE | Dosage: If the benefit design for a prescription plan doesn't?t require a minimum of two co-pays for a 90-day of supply, then the plan will actually lose money versus the member buying three months of medication at retail (and paying three co-pays).
  • TWO | Wastage: There can be significant and increased wastage when members get a 90-day supply of medication as opposed to 30-days at a retail provider.
  • THREE | Cost Controls: Mail service pharmacies often do not put the same cost controls on their own operations that they do on their retail networks.

 


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