New PBM Study On Medication Waste

       Is there a significant difference between the amount of prescriptions wasted that were dispensed from retail pharmacies versus mail-order facilities?  One study just released attempts to address this question. 

       According to this Yahoo article, there is a new study released by Visante that looks to compare prescription waste.  The study, commissioned by the Pharmaceutical Care Management Association (PCMA), found that waste was lower for mail-order prescriptions compared to prescriptions filled at traditional retail pharmacies. 

       According to their results, mail-order pharmacies attributed for only 1/3 of the wasted prescriptions dispensed to Medicare patients.  The other 2/3 was attributed to traditional drugstore prescriptions. 

      They also found that less than 1% of total prescriptions filled for Medicare patients were wasted (meaning filled but never taken by the patient).  Visante found that overall prescription waste was rare and it was attributed to factors such as auto-refill programs or patient death. 

      It’s easy to get lost in the numbers if you look through the actual report.  But the overall goal of this study was simple, make community pharmacies look bad and make mail-order pharmacies look good.  Keep looking if you hope to find a true waste comparison report. 

      This study was commissioned by the organization that represents pharmacy benefit managers (PBMs).  They have a vested interest in making community pharmacies look bad when compared to mail-order pharmacies.   The PBM industry fuels the mail-order pharmacy business because they usually have an ownership stake.

      An independent study would carry a lot more weight.  Furthermore, clarification on the exact methods of data collection used to compile the results would also help anyone seeking to find useful comparison information. 

      This study is merely a promotional product for the mail-order pharmacy industry.  Mail-order pharmacies want to be seen as the model of efficiency.  Their goal is to shift more business away from retail pharmacies.

      Their focus on waste related to a patient’s death is curious.  By the study’s own admission, only a small percentage of prescription waste is associated with the death of a patient.   I never saw anything related to prescriptions being lost in the mail or sent to the wrong patient.  Those numbers are left unreported. 

      The PCMA is trying to convince our government that mail-order pharmacies are a better choice for Medicare prescriptions.  They want to prove that mail-order is less expensive. 

       I have always challenged the idea that mail-order pharmacies are less expensive.  A true cost-comparison analysis would show that mail-order pharmacies only gain pricing advantages through artificial means such as discounts.  And an honest look at waste would evaluate it from all sources.

       Community pharmacy has been under assault by the PBM industry for quite some time.  Mail-order pharmacies only compete with traditional pharmacies because patients are forced into using them. 

       If mail-order pharmacies were really the clear choice over traditional community pharmacies, there would be no need for discounted co-pays or mandatory mail-order plans.  Patients nd insurance plans would shift their business to mail-order pharmacies on their own. 

       You don’t have to subsidize a good idea.   You don’t need to mandate the most sensible choice to consumers.  This is simply a way to push the government further towards mail-order. 

       This is the battleground retail pharmacy now finds itself.  How do we fight an industry so rich and powerful it can create it’s own truths?  How do we combat a study designed specifically to make us look bad?  We need to answer these questions soon before the PBMs of the world answer them for us.

The Redheaded Pharmacist

3 Comments to “New PBM Study On Medication Waste”

  1. By Kevin, March 8, 2013 @ 12:08 am

    The PBMs have been feeling the heat from pharmacists photographing and documenting widespread mail order waste, and more recently Medicare officials speaking up on this issue. You are right to call them out and your description of PBMs creating their own truths is spot on.

    Community pharmacists who come across mail order waste, please document it, take a picture and send it to NCPA to go in the Waste Not, Want Not presentation featured on the association home page.

    You can read our full response to PBM arguments on this here:


  2. By Pharmaciststeve, March 9, 2013 @ 10:50 pm

    here is an excerpt of a video that explains how the PBM’s “play” with the number to convince employers that they are the best thing since sliced bread


  3. By Wrong Aid, March 11, 2013 @ 4:26 pm

    And the big 3 and their auto-fill programs? That’s not only waste but a public danger.


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