Under insurance contracts, it's often cheaper to buy maintenance drugs via mail order, making it a tough sell for pharmacies.
By MARK ALBRIGHT
Published October 11, 2003
The nation's drugstore chains are trying to win new pharmacy customers, and keep their hold on current customers, by making their stores more convenient to millions who take maintenance drugs.
Eckerd Corp. and Walgreens say the percentage of pharmacy customers signing up for automatic refill service has been rising sharply. CVS, which has 66 stores in Florida, is looking at initiating the service.
"Our automatic refill business has been doubling year over year," said Jerry Thompson, senior vice president of pharmacy services for Largo-based Eckerd, the nation's fourth-largest drugstore chain. "It's millions of customers, but it's still less than 10 percent of our pharmacy customers."
Seniors, who are more reliant on drug therapy than any other segment of the population, take 38 percent of all refills. About 25 percent of the population over 65 takes three or more prescription drugs daily, according to the Pharmacy Society of Wisconsin.
Customers have to sign up for automatic refills in advance. Then the drugstore computer prompts the pharmacy staff to package a refill for pickup five to seven days before the patient is forecast to run out of pills. The computer telephones and leaves a message that a refill is waiting to be picked up. If a customer wants, the drugstore will call the doctor to get more refills approved. "It's all automated," said Eckerd spokesman John Sensabaugh.
The drugstore chains like the automatic refills for a variety of reasons. About half of the entire pharmacy refill business today is composed of patients using maintenance drugs to treat such ailments as hypertension, high cholesterol or acid stomach.
Drugstore executives say automatic refills help doctors and insurance companies better monitor whether patients are taking all their medication as prescribed.
"If the customer says he has pills left over, the pharmacist has a talking point when the customer picks up the refill," Thompson said.
The stores schedule the order filling for nonpeak hours, which cuts down the wait for others at the pharmacy counter. About half of the refill orders at the typical Eckerd are phoned in and keyed in by touch-tone for later pickup. This year Eckerd added the option of signing up for automatic refills on its Web site, Eckerd.com. The service also gives the drugstore chains the hope of getting back some of the refill business they've lost to mail order pharmacies - if an insurance carrier or employer is willing to go along. It's a service that's negotiated with each insurance contract. Some pharmacy benefit plans require all 90-day prescriptions be filled by mail. While most give customers the option of picking up a 90-day supply from a store, typically the plans require a much higher co-payment for a 90-day prescription filled at a store.
"There's no law stopping us from filling 90-day prescriptions at stores, only insurance contracts and regulations," said Michael Polzin, a spokesman for Walgreens, based in Deerfield, Ill., "We've been lobbying to change insurance contracts that allow us to fill 90-day prescriptions so more people will use automatic refills."
Walgreens and Eckerd both say it has been a tough sell.
About 90 percent of drugstore customers use some sort of insurance to help pay for prescriptions. Rules prohibit prescriptions billed to some Medicare and Medicaid programs from being put on drugstore automatic refill programs.
