We Have Everything Else Delivered. Why Not Prescriptions?

Retail ecommerce sales surpassed the $1 trillion mark last year, growing an average of 21% annually since 2020 began. Depending on the source, the number of digital buyers in the United States stands somewhere between 210 and 270 million, as high as 70% of the population.

That’s a lot of package deliveries.

Several polls suggest a similar percentage of Americans are on at least one prescription drug. Why are relatively few of us having those prescriptions delivered?

Apparently, some people enjoy waiting in line at the pharmacy. Which is strange because prescription drugs are the ultimate commodity. We can’t compare them to others on the shelf. No one can try them on. They can’t be returned or exchanged. Most medications are purchased over and over again. They certainly never go on sale.

Speaking of cost, studies have shown that prescription delivery saves patients money up front and leads to lower healthcare costs thanks to better medication adherence. Given the cost, convenience and adherence benefits, you’d think every prescription would be delivered.

Not quite, not yet.

Growing, But Still Lagging

It’s not like no one has prescriptions delivered to their doors or mailboxes. Each year, CoverMyMeds surveys 1,000 patients on their fulfillment patterns and preferences for its annual?Medication Access Report. The latest data show:

• 9 in 10 patients said they had visited a pharmacy in person during the past 12 months.
• Over half (56%) had most often filled their prescriptions at a local retail pharmacy; only 24% said they most often received them through delivery services.
• 52% of patients said they would prefer delivery vs. in-store pick-up.

Rx Savings Solutions?conducted similar consumer research in fall 2022. While the sample surveyed was slightly smaller and less selective, the findings were similar:

• Almost half (46%) of survey respondents had used a delivery service at least once.
• 41% said they are likely or very likely to use an online pharmacy to fill and deliver their medications.
• 37% said they were unlikely or very unlikely to do so.

Pre-pandemic data from National Institutes of Health show that prescriptions may actually have been ahead of their time in the delivery game. In 1996, hardly anything beyond pizza and furniture was delivered, but a full 7% of U.S. adults had at least one prescription delivered. However, it took 22 years for that figure to eclipse 10%, most commonly with adults aged 65 or older.

Digital or Brick-and-Mortar?

No doubt the pandemic caused a spike in home delivery of consumer goods across the board. It also narrowed the adoption gap for prescription drug delivery. But a gap still exists. Is there something about prescriptions or brick-and-mortar pharmacies that makes consumers reluctant to delivery or unaware of the option?

More than one in three people (36%) RxSS surveyed last fall sound like they may never go the delivery route. Familiarity was somewhat strong (47%) with mail-order through insurance, but much lower (<3%) with online, delivery-only pharmacies like Amazon Pharmacy and Mark Cuban CostPlus Drug Company.

Ongoing pharmacist and staff shortages in retail pharmacies could help drive adoption for prescription delivery. The?Wall Street Journal?reported in late January that CVS, Walgreens and Walmart all announced reduced pharmacy hours at a majority of their stores. That compresses the window of time for working adults to pick up prescriptions, and will likely lead to longer wait times no matter the time of day.

Delivery would also seem the logical choice for anyone living in a “pharmacy desert,” now defined by geographic distance from the closest pharmacy, as well as access to transportation needed to reach, both of which can negatively affect rural and urban populations.

The 2023 Medication Access Report from CoverMyMeds provided insights into the prevalence of medication access delays and the resulting consequences:

• 65% of patients experienced a delay of at least 24 hours to pick up their medication, and 11% have waited a week or longer.
• Of patients who experienced a medication delay, 40% cited insurance barriers and 38% cited delays in communication—such as waiting on a doctor or nurse for answers.
• 60% of patients who experienced a medication delay self-reported increased anxiety and/or stress, 40% said their symptoms worsened, and 18% reported progression of their condition.

Options Galore and Multiplying

If your go-to retail pharmacy didn’t offer prescription delivery before the pandemic, it probably does now.

Depending on their prescription benefit, people on recurring “maintenance” medications often have no choice but to receive their prescriptions through mail-order. Obviously convenient, but not always the most economical. The same drug might be cheaper instore at a different in-network pharmacy, or perhaps with a discount card toward the cash (non-insurance) price, or if filled and delivered by a “digital” pharmacy.

The aforementioned Amazon Pharmacy and Mark Cuban CostPlus are two examples, but each week seems to bring a new digital pharmacy to market. The?National Association of Boards of Pharmacy?currently lists 85 accredited digital pharmacies. Essentially, they are accessed purely through an online rather than physical storefront. Prescriptions still must be sent by a physician or equivalent prescriber and dispensed by licensed pharmacists. The pharmacies themselves are subject to all the same regulations as your neighborhood pharmacy.

Making Sense of it All

No doubt, the prescription drug market is expanding with more companies competing for our prescription dollars. The market is betting that whatever reasons consumers may have against having medications delivered will eventually fade away.

And yet, today, the average consumer doesn’t know they have more options than ever, let alone how to sift through them all and find the best combination of cost and convenience. “Aggregator” platforms like Amazon, eBay, Etsy and Shopify give online shoppers that capability for all kinds of consumer goods, but there’s nothing so comprehensive in the pharmacy space yet.

Maybe that’s why so many consumers who order everything else online and have it delivered to their door still drive to the pharmacy and wait in line.