By: Pooja Patel, PharmD Candidate c/o 2013
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In response to the article on the controversy surrounding Bill 5502, a few things must be mentioned. Bill 5502 forbids insurance companies from requiring patients to use mail-order pharmacies for their medications if they want to avoid extra fees. The argument mentioned by Ms. Danesh-Yazdi (that this would take away business from mail-order pharmacies and cause an increase in cost to the patient) might not necessarily be true. Bill 5502 is not requiring patients to fill their medications at community pharmacies versus mail-order; it is simply giving them an option. The bill prevents insurance companies from charging extra fees for using a community pharmacy over mail-order pharmacy only if the prices are “comparable.”
In essence, it is my belief that although there might be a shift in business from mail-order to community, it will not decrease competition or raise prices significantly. Community pharmacies will still have to maintain low prices to remain “comparable” to the prices charged by mail-order pharmacies. Patients will have an opportunity to choose the method that is most convenient to them rather than worry about insurance coverage. Regardless, the mail-order method might still be the most feasible for patients who are currently using it. It allows patients to continue visiting a community pharmacy and also enable greater access to pharmacist-provided counseling.
It is unreasonable to think that there will be no negative impacts from this bill‘s passing – there will indeed be a decrease in mail-order pharmacy business. Some may not meet their quotas and will subsequently raise their prices, but this will not drive up price nor shut down all mail-order. The benefits that the patient will gain, namely convenience and face-to-face counseling, will far outweigh the increase in cost to the patient that we may see. Bill 5502, in the long run, will not only increase competition between community pharmacies and mail-order pharmacies, but also benefit the patient.
