Wednesday, March 26, 2008

Mail Order Pharmacy

Mail order prescription services are known to your medical insurance companies as Pharmacy Benefit Managers (PBM's).

PBM's are middlemen that obtain contracts with pharmaceutical manufacturers ("drug companies") for discount prices on large sales volumes for the insurance companies. In theory, this is supposed to be a win-win situation for everyone. The insurance companies save money on cost of medications, they incentivize you to participate by lowering the out-of-pocket cost of your pills, and otherwise pass on the savings to you.

Of course, you could reasonable ask why your premiums keep going up, but that's a topic for another time. You might also ask what that's doing to your friendly and trustworthy local pharmacist, but I guess the idea is that it's a tough old world out there.

If you want to use your PBM, and would like our help in making it work for you as smoothly as possible,
  • They will usually send you a renewal form for each of your medicines when your yearly prescription is up.
    • Please let us use these for renewals. Using hand written prescriptions for renewing already existing prescriptions is very confusing to them.
  • PLEASE, PLEASE USE YOUR LOCAL PHARMACY FIRST FOR NEW MEDICINES OR FOR CHANGES IN DOSES ON MEDICINES!
    • It's not unusual to start or change a medicine, only to find that you have to switch to something else because of side-effects, or that you have to make another change in dose at the follow-up visit.
    • Because of this, it's a good idea to make sure that the medicine and it's dosage is right for you before getting 3 months worth for a year!
    • Yes, we know it's cheaper to do mail order.
    • Yes, we know a few dollars is a lot of money these days, especially if you are on a fixed income.
    • The problem is that serial mail-in prescriptions reflecting changes in medications and/or dose changes can lead to confusion as to your medications.

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