Blue Cross Blue Shield of Minnesota will now let members fill 90-day prescriptions in retail pharmacies rather than forcing them to use mail order, according to the New York Times (In Switch, Insurer Lets Stores Fill 90-Day Prescriptions). Patients prefer retail because of the convenience and access to pharmacists, but mail order is more cost effective. Retailers are being squeezed on price by Blue Cross, but are willing to make low margins in order to increase customer traffic.
Pharmaceutical Benefit Managers (PBMs) with mail order operations, such as Medco and Caremark, make a lot of money on mail order. One reason is that the mail order process gives the PBMs a greater opportunity to shift patients to drugs that provide higher rebates for the PBMs.
Interestingly, one of the reasons commercial payers are starting to allow 90 day prescriptions at retail is that Medicare beneficiaries will soon have the same privilege under the Medicare drug benefit. It’s just one more example of Medicare setting the pace for the industry.April 16, 2005