Almost 1,200 seniors have complained to Medicare this year about problems with mail order pharmacies, including shipment of unneeded medication and having to go without medication because delayed shipments, according to documentation recently released by the Centers for Medicare & Medicaid Services (CMS).


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NCPA: CMS documents reveal mail order Rx complaints

December 17th, 2013

ALEXANDRIA, Va. – Almost 1,200 seniors have complained to Medicare this year about problems with mail order pharmacies, including shipment of unneeded medication and having to go without medication because delayed shipments, according to documentation recently released by the Centers for Medicare & Medicaid Services (CMS).

The National Community Pharmacists Association said Tuesday that beginning Jan. 1, CMS will require Medicare Part D prescription drug plans (PDPs) to ensure that their contracted pharmacies get consent from a beneficiary (or their caregiver) before shipping or delivering a new or refilled prescription.

NCPA noted that the change stems from patient complaints received by CMS and NCPA-documented cases of individuals turning large amounts of unused or expired medication — often provided through mail order auto-refills — into community pharmacies for disposal. 

"We commend Medicare officials for acknowledging mail order waste and for responding to the concerns of patients and community pharmacists by implementing this new policy," NCPA chief executive officer B. Douglas Hoey said in a statement. "The complaints chronicled by CMS speak for many patients and underscore the fact that mail order is not for everyone. Patients deserve a choice to opt for the pharmacy provider that best meets their individual health care needs. The new policy CMS is implementing should benefit patients and reduce medication waste through mail order."

The patient complaints released by CMS, which are documented by the PDP or pharmacy benefit manager (PBM) involved, included medication waste, "surprise charges," more expensive branded drugs used over generics, and shipping problems, according to NCPA.

For example, many patients reported receiving medication that they didn't order and couldn't return. And after their physician changed their prescription drug regimen, some patients continued to receive supplies of the old drug or dosage, and mail order wouldn't reverse the transaction. One patient complained of already having a 15-month supply on hand.

In addition, some patients said they had to go days or weeks without their medication because of delays or shipments to the wrong address.

Other complaints included patients being charged for refills without having authorized them, medication with a higher co-pay delivered without patient consent, and prescriptions being filled with a costlier brand-name medication when the patient/doctor expected a generic.

"Community pharmacists often hear firsthand about patients' unfortunate experiences with mail order," Hoey added. "Most of these problems cited by seniors are avoidable in community pharmacies, where a patient talks to a health care provider face-to-face. Patients don't accumulate 15-month supplies of excess medication and then walk in to ask for another refill. Community pharmacists intervene so patients don't go days or weeks without their medication."

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