Letter: Mail order threatens family pharmacies

To the editor,

It was with sadness that I read Paul Singley’s article on the closing of Nelson’s Pharmacy. We wish our colleague and friend Gerry Russo all the best in his retirement. 

And so it appears that another family pharmacy small business is swallowed up by a corporate big box pharmacy. Despite this symptom, it is not the big corporate pharmacies that are necessarily the root cause of the demise of the family pharmacy. To the contrary, given the choice, most consumers prefer the friendly, familiar environs of the local neighborhood drug store. The pharmacists and technicians know their patients personally, and the service is driven by genuine care and concern for their well-being.

Mr. Singley hit the nail on the head in citing mandatory mail order pharmacy as the biggest threat to the existence of the family pharmacy. These insurance-driven factory pharmacies have done an exceptionally good job of convincing large corporations like Sikorski, GE, IBM, and countless others, that they will save money by taking away their employees’ choice of where to receive their medical care. Unfortunately, the truth is that mail order pharmacy is not more cost effective than traditional pharmacy. National Community Pharmacy Association studies have proven time and time again that the actual total cost to the consumer is actually higher when mail order is used. 

Mail order pharmacy rules mandate that all prescriptions be for 90 day supplies. This leads to tremendous waste when dosages are changed for patients or doctors are trying a variety of drugs to determine which work best for a patient. When they fail to get the medication to their customers on time, as we see on a painfully regular basis, the mail order pharmacies force their customers to pay an additional copay for a small holdover supply. Where? At the local community pharmacy, of course. That’s right, local independent pharmacies fill 10-day supplies, at virtually no profit, to cover for the mail order firms because we care enough to not let people go without their medications.

Even our governor has fallen victim to the convincing arguments of the big prescription benefit managers like Caremark, which is owned by CVS. His decision two years ago requiring all state employees to obtain their prescriptions via mail order forced thousands of dedicated customers to leave their preferred pharmacies in favor of CVS/Caremark. 

The sad part is that the governor doesn’t even really know if he has saved anything on this decision. Oh yes, he and his minions will point to the $20 million that he predicted he would save. Where did he get that number? He got it directly from CVS/Caremark of course, so it must be true, mustn’t it? 

Despite exhortations from independent community pharmacies that the state audit CVS/Caremark and make them prove the predicted savings, the governor has steadfastly refused to do so. The state is self insured, and so must pay for the cost of each prescription in addition to the insurance premiums covering them. Without an audit there is no way to ensure that we are not being over charged or that expensive brand medications are not being used in place of inexpensive generics. (Did you know that the PBMs negotiate rebates from the brand drug manufacturers, but keep them themselves and don’t pass them on to the state?) So, what could Gov. Malloy be afraid that an audit might uncover? 

Gov. Malloy should either prove the state’s savings via an audit, or relent and let the state employees purchase their prescriptions wherever they choose to do so. Or, more and more family pharmacists will be joining our friend Gerry on the golf course, and consumers will have less and less choice in their medical care.

Bob and Marion Bradley

Owners of Beacon Falls Pharmacy

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