As long as cost isn't a factor, patients tend to stick with what's familiar when it comes to filling prescriptions via mail order or at a retail pharmacy, a CVS Caremark Corp. study found.

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CVS examines choice of retail vs. mail order Rx

January 19th, 2011

WOONSOCKET, R.I. – As long as cost isn't a factor, patients tend to stick with what's familiar when it comes to filling prescriptions via mail order or at a retail pharmacy, a CVS Caremark Corp. study found.

The company said Wednesday that the research, conducted by researchers from CVS Caremark and Harvard University and published in the January edition of the Journal of the American Pharmacists Association (APhA), revealed that consumers split their preferences mainly based on past experiences when offered a cost-neutral choice to fill 90-day prescription medications in a retail store or through a mail-order pharmacy.

CVS Caremark, which operates 7,100 retail drug stores and a pharmacy benefit management business, called the study the first of its kind. Researchers reviewed the actions of about 325,000 plan members switching from pharmacy benefit plans requiring mail order use for maintenance medications to CVS Caremark's Maintenance Choice over the first four months of the program, which began in January 2009.

Maintenance Choice lets members fill their 90-day maintenance prescriptions via mail or at a CVS/pharmacy store for the typically lower mail-order price and with reduced co-pays that are usually charged for mail prescriptions. CVS Caremark said it first offered Maintenance Choice in early 2009 as an option for plan sponsors that have or are considering a voluntary or mandatory mail prescription plan.

In the study, researchers assessed the selection of retail or mail pharmacy channels among people who initiated therapy under Maintenance Choice and among those who had previously started therapy under a mandatory mail plan. The findings showed that of the members who previously got their prescriptions through mail, 76.3% chose to stay with mail service, and 23.7% moved their prescriptions to retail.

For the group that was just initiating therapy for a recently diagnosed, long-term chronic illness, 44.3% selected retail as their pharmacy of choice, while 55.7% chose mail service. For members with no previous experience using a mail pharmacy, nearly 68% selected retail pharmacy for their maintenance medication prescriptions.

"These results highlight the importance of constructing pharmacy benefit designs that provide members with affordable access to both retail and mail pharmacies," Troyen Brennan, executive vice president and chief medical officer of CVS Caremark, said in a statement. "While it is clear people like having options, their preferences appear to depend on factors such as driving distance to a pharmacy, prior experience with mail service and age, with those who are younger favoring retail."

A key finding from the study showed that members in Maintenance Choice plans tend to be more adherent to their medications, according to Brennan. "We are looking for ways to encourage people to stay on their medications as prescribed because it is one of the most cost-effective ways to manage a plan's health care costs and improve patient outcomes. Choice and convenience for consumers makes a difference in helping people stay adherent," he noted.

The Maintenance Choice study was conducted as part of a previously announced three-year collaboration between CVS Caremark, Harvard University and Brigham and Women's Hospital to research pharmacy claims data to better understand patient behavior around medication adherence.

Earlier this month, CVS Caremark released research from the collaboration finding that patients with complex therapies are struggling to stay on their medication regimens and that patients who take medications as doctors direct could save the health care system as much as $7,800 per patient yearly. And another study released last week showed that some physicians remains uncomfortable prescribing generic medications.