Why Aligning With the Right PBM Ensures Timely Access to Medications

Mail delays have little impact upon Navitus members. Find out why.

Since March, we have seen an uptick in the number of members participating in retail extended or mail order prescriptions. At the same time, there have been anecdotal accounts of delays at the United States Postal Service (USPS). Fortunately, these delays have had only a minimal effect upon Navitus members.

Maintenance medications dispensed by our mail order pharmacies represent only about 3% of our claims volume. The effect of any degradation of mailing services from the USPS has a limited impact on Navitus, as very few members receive prescriptions via USPS. Local retail pharmacies fill most of our 90-day prescriptions, which are about 25% of our claims volume.

Since the coronavirus began to impact the U.S., we have experienced a slight slowdown of USPS deliveries with one-to-two day delays nationwide among a small percentage of our deliveries.

Scott Knower, CEO of the American Pharmacists Association, said medication compliance “is everything” when it comes to achieving good health outcomes.¹ As such, we at Navitus take our commitment to providing timely medication delivery very seriously so members can get their medication on time and can continue their course of therapy. We also do everything we can to make medications as affordable as possible, removing yet another barrier to adherence.

In today’s blog, we’ll explore a few recommendations to ensure that members receive their maintenance medications on time. Here’s what you need to know:

GUARDING AGAINST DELAYS – ORDER AHEAD OF TIME

Our mail order partners, Costco and NoviXus, recommend allowing a minimum of one week for the dispensing of refillable prescriptions and delivery to the member’s home. For new prescriptions, they recommend allowing two weeks for dispensing and delivery, which enables the pharmacy to do any necessary follow-ups with the prescriber.

ENSURING MEMBERS HAVE TIMELY ACCESS TO THEIR MEDICATIONS

If members call us to let us know they have never received their prescription and that it may be lost, we simply send another prescription and expedite the shipment for delivery as soon as possible for this much needed medication – no questions asked. This is part of our promise to our clients to ensure timely, accurate delivery of medications.

We also have contingency plans to ensure timely medication delivery, including the use of local pharmacies to dispense emergency prescriptions when delivery has failed or been delayed. We are using UPS for all cold pack and overnight deliveries, as well as piloting their mail innovation program for non-temperature sensitive orders. This program bypasses the USPS sorting facilities and passes the package to the post office for the final mile.

Our fully-owned specialty pharmacy, Lumicera Health Services, provides home delivery prescriptions to members nationwide who have chronic conditions. These medications often require very specific, continuous storage conditions while in transit, so these deliveries are time-sensitive. As a result, Lumicera ships the vast majority of medications for next-day delivery and exclusively uses national carriers (UPS/FedEx) for our shipping. We’re pleased to report that we haven’t experienced any delays at all on these prescriptions.

To help further assure these critical shipments deliver to members’ on time, Lumicera utilizes several resources to identify potential shipping issues before they occur and works with third-party parcel monitoring companies and carrier support to expedite delivery should an unforeseen delivery delay occur.

At the end of the day, plan sponsors want a PBM that not only delivers savings, but a partner they can trust to align with their goals. Not only does Navitus provide clinically sound, cost-effective solutions, but we are also committed to ensuring that members get the medications they need when they need them, receive them at an affordable price and can use them to improve their health and quality of life.

To learn more about how Navitus can help you minimize employee costs while maximizing savings, take a minute to explore the following case study.

Compassion International, a child-advocacy ministry, faced rising employee prescription drug costs but was unwilling to compromise on its excellent employee benefits.

By reevaluating its reliance on a traditional pharmacy benefit manager (PBM), the organization was able to realize double-digit cost savings—at a time when most employers experienced double-digit cost increases—without compromising patient care.

By revisiting its existing PBM offering, Compassion International found a trusted partner that aligned with its interests and produced results.

How did they do it?

Compassion International gained the flexibility and guidance to fully realize its employee benefits vision, resulting in a co-developed benefit management strategy that combined its objectives with Navitus’ transformative pass-through approach, lowest-net-cost philosophy, and outstanding clinical care model.

Mail Delays Highlight Pitfalls of Prescription Drug Home Delivery. Modern Healthcare. https://www.modernhealthcare.com/insurance/mail-delays-highlight-pitfalls-prescription-drug-home-delivery. Published August 19, 2020. Accessed August 24, 2020..