Patients split on filling 90-day Rx's at retail or through mail-order

WOONSOCKET, R.I. — When consumers are offered a cost-neutral choice to fill their 90-day prescription medications in a retail store or through a mail-order pharmacy, they tend to split their preferences, largely depending on their past experiences, according to the findings of a first-of-its-kind study from CVS Caremark.

The study, published in the January edition of the Journal of the American Pharmacists Association, the peer-reviewed journal of the American Pharmacists Association, reviewed the actions of approximately 325,000 plan members who were transitioning from pharmacy benefit plans that required mail pharmacy use for maintenance medications to Maintenance Choice over the first four months of the program, which began in January 2009. Maintenance Choice is a plan design that gives members the option to fill their 90-day maintenance medication prescriptions through mail or at a CVS/pharmacy — for the typically lower mail-order price and with reduced co-pays that are typically charged for mail-order prescriptions.

Maintenance Choice first was offered two years ago by CVS Caremark as an option for plan sponsors that have or are considering a mandatory or voluntary mail prescription plan. The study conducted by researchers from CVS Caremark and Harvard University assessed the selection of retail or mail pharmacy channels among individuals who first initiated therapy under Maintenance Choice and among those who had previously started therapy under a mandatory mail plan design. The findings showed that of the members who previously got their prescriptions through mail, 76.3% chose to stay with mail service, while 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% selected mail service. For members who had 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," stated Troyen Brennan, EVP and chief medical officer of CVS Caremark. "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."

Brennan added that an important finding from the study showed members in Maintenance Choice plans tend to be more adherent to their medications.

The Maintenance Choice study is part of the CVS Caremark research effort aimed at better understanding how consumers interact with their pharmacy care provider so that they stay adherent to their medications. The 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.