Modern Healthcare

Mail delays could give PBMs headaches

- By Shelby Livingston

MAIL DELIVERY HAS BECOME big business for pharmacy benefit managers as they look to keep down costs within their own organizati­ons. CVS Health reported $52.1 billion in mail-order pharmacy revenue in 2019, up 10.8% over 2018. CEO Larry Merlo told analysts this month that prescripti­on home-delivery volume increased 500% in the second quarter of the year over the first quarter amid the COVID-19 pandemic.

But in recent months, some prescripti­on home-delivery providers have had trouble getting medication­s to patients on time through the U.S. Postal Service, which is embroiled in a political fight over its budget, mail-in ballots and the November election.

Humana Pharmacy, part of Medicare Advantage insurer Humana, said increased small parcel shipping volumes are affecting all delivery carriers. It said it’s working with the Postal Service to ensure prescripti­on home deliveries remain a priority. “Humana is updating internal processes to reduce overall turnaround times, we continue to provide our customers with informatio­n about their shipment’s status, and we’re looking at additional ways to expedite shipments,” a spokeswoma­n said in an email.

Alan Van Amber, senior vice president of provider services at Navitus Health Solutions, a PBM owned by hospital system SSM Health, said that while the company sends few prescripti­ons by mail, it has seen one- to two-day delays nationwide among a small percentage of those prescripti­on deliveries. He noted a general slowdown in Postal Service deliveries since the pandemic began and throughout national protests following the killing of George Floyd.

The company is advising members that could be affected to refill prescripti­ons earlier than normal. It allows patients to seek emergency prescripti­ons at local pharmacies when delivery problems arise.

The dominant PBMs, including Express Scripts, CVS and OptumRx, either said they haven’t experience­d any issues or declined to say if they are dealing with Postal Service delays. CVS said it is “closely monitoring the current situation” and working to ensure prescripti­on deliveries are made on time. ●

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