The recent, sudden disruption of U.S. Postal Service (USPS)
deliveries has caused concern about people receiving their medications later
than they normally would. While news reports and statements by lawmakers
indicate that many Americans have lost prescriptions in the mail or received
them late, drug benefit and supply chain experts say the disruption to the most
vulnerable patients served by specialty and mail order pharmacies should be
minimal.
An Aug. 24 Axios-Ipsos poll shows that one in five Americans
received medication through the mail during the preceding week. One in four of
that group, or 5% of Americans overall, didn't receive their medication or got
it late.
In addition, PBMs have not reported significant disruption to
their supply chains.
"Most of the drugs shipped from a mail order pharmacy — a
non-specialty pharmacy — you worry about them being perishable, but they tend
to be pretty stable. They’re oral pills, things like that," says Mike
Schneider, a principal at Avalere Health.
Schneider also suggests that mail order pharmacies' longer
fills, which typically keep shipping costs down by filling for 90 days or more,
should insulate patients from major disruptions. He adds that most mail order
medication businesses also build logistical complications into their shipping
schedules.
Omar Hafez, a principal at Avalere and a former supply chain
executive at specialty pharmacy McKesson Specialty Health, says that time- and
temperature-sensitive therapies have very specific delivery windows that are mandated
by law. He says the strict requirements mean that the bulk of the supply chain
for temperature-sensitive specialty drugs is managed by specialized logistics
firms, not the USPS.
Schneider says the pharmacy supply chain as a whole has proved
remarkably resilient over the course of 2020 — despite the tumult caused by the
pandemic and the USPS brouhaha.
"I think a lot of supply chain issues never really
materialized, at least not to my knowledge," Schneider says. "There
are a certain drugs that have shortages, but nothing that seemed like it was a
national emergency. I think part of the reduced supply might have been
everybody was going and filling their prescriptions as the virus was hitting,
and everybody was getting some longer-term fills."
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