WESTLAKE VILLAGE, Calif. — Patient satisfaction with mail-order pharmacies continues to decline, according to the latest survey by J.D. Power and Associates. Overall satisfaction with brick-and-mortar pharmacies, meanwhile, has held steady.

The 2012 edition of the J.D. Power and Associates U.S. Pharmacy Study showed that overall satisfaction with mail-order pharmacies fell to 792 (on a scale of 1,000), 14 points below last year’s score and 22 points below the average satisfaction score for brick-and-mortar, or retail, pharmacies. It was the second consecutive year of significant decline in satisfaction for mail-order pharmacies, most of which are operated by pharmacy benefits managers (PBMs).

In the survey, pharmacy customers rated retail pharmacies on five factors: prescription ordering and pickup process; cost competitiveness; non-pharmacist staff; pharmacists; and store. Mail-order pharmacies are judged on four points: cost competitiveness, prescription ordering, prescription delivery and customer service.

Beyond the steep overall decline for mail order, customer satisfaction with each of the four points fell, particularly in cost competitiveness, which heretofore has been touted as a competitive advantage for mail order.

“The erosion in customer satisfaction with mail-order pharmacies may foretell challenges to their business model, as prior to 2011 customer satisfaction was more equivalent to the brick-and-mortar experience,” says Rick Millard, senior director of health care practice for J.D. Power. “Acceptance of mail-order programs grew by offering customers convenience and lower costs. While this has been a successful approach, the mail-order business needs to continue to adapt to meet customers’ increasing ­expectations.”

The study did find that satisfaction was much higher among patients who choose to use mail order (810) compared with those who are required to use it (768). Those who voluntarily opt to use mail order also expressed greater satisfaction with that channel’s cost ­competitiveness.

While convenient location was rated the most important reason for choosing a specific retail pharmacy, customer service is increasing in importance, Millard adds. The survey also suggests that service at the pharmacy counter may be related to front-end purchasing. Among the 23% of retail pharmacy customers who speak with a pharmacist in person, 61% also buy over-the-counter medications during their visit, while only 24% of those who do not consult with a pharmacist make an additional O-T-C purchase.

Among chain drug pharmacies, the three banners operated by the leading drug wholesalers for independent pharmacies rated highest, with McKesson Corp.’s Health Mart garnering the top score of 848 and AmerisourceBergen Corp.’s Good Neighbor Pharmacy chain tying for second at 843 with Cardinal Health Inc.’s Medicine Shoppe Pharmacy. Walgreen Co. ranked third with 804 points, followed by Rite Aid Corp. (798) and CVS/pharmacy (780).

“Patients expressed a clear, unmistakable message in this survey: They want the ability to choose the pharmacy option that best meets their needs and those of their families,” said Lonny Wilson, president of the National Community Pharmacists Association, who noted that the survey’s findings were consistent with those conducted separately by Consumer Reports magazine and other organizations. “Patients have found independent community pharmacists to be an unsurpassed value for patients in terms of their accessibility, customer service, knowledge and competitive pricing.”

Among mass merchants, Walmart’s Sam’s Club division took top honors with 838 points, followed by Target Corp. at 835 and Costco Wholesale Corp. with 819. Meijer Inc. (816), Kmart (803) and Walmart (782) rounded out the ratings.

For the third consecutive year, Publix Super Markets Inc. led supermarket pharmacies in customer satisfaction with an impressive score of 872, followed by Wegmans Food Markets Inc. with 861. BI-LO Inc. (including the acquired Winn-Dixie pharmacies) ranked third at 842, with Hy-Vee Inc. and H-E-B taking fourth and fifth places with 829 and 827 points, respectively. It is interesting that four of the five top-rated supermarket pharmacies are privately held companies, while Publix is an employee-owned operator.