Since its inception, the U.S. Postal Service has been an integral part of our country’s ability to share information and goods. Today, operational changes both proposed and already in effect at the USPS have led to mail service delays, with far-reaching consequences. While the focus on our democratic election process is crucial and a good fight, the effects ripple across our country and are already being felt by many.
The practical impact of these changes is so greatly felt that emergency congressional hearings are underway. The deliberate slowdown of the USPS raises serious concerns about timely medication access, which could lead to negative health outcomes — especially for our most vulnerable.
The postal service has become a vital part of the U.S. health care system. Disruptions to the U.S. Mail will create barriers to health care access for those who depend on the Postal Service for their medications.
While typically around five percent of prescriptions filled in the U.S. are through mail-order channels, a recent consumer survey conducted by AMCP and the Alliance of Community Health Plans found that nearly a quarter (24 percent) of respondents shared that they depend on the mail for their medicines during the pandemic. For the millions of Americans who rely on mail-order medications, the delays have made medication delivery less reliable and unpredictable, jeopardizing health outcomes.
Mail service medication delivery is a valuable tool used to increase patient safety, offer patient convenience, and maintain the affordability of prescription drugs as a whole. There is also evidence that postal service medication delivery improves adherence and lowers dispensing error rates — both critical to improving patient health outcomes.
With telehealth doctor visits increasingly popular due to COVID-19, mail-order pharmaceuticals are the next step to ensure patients receive care while staying at home, by providing medications to their doorsteps. This provides a safer alternative to in-person visits and is particularly critical for high-risk individuals. Mail-order prescriptions are often used for maintenance medications and the management of chronic diseases, and by individuals with certain chronic diseases who are most at risk for COVID-19.
Delays also have a disproportionate impact on communities that often already lack sufficient access to medical care. While patients in city centers may be able to turn to an emergency prescription at a local community pharmacy, which can still present problems, rural communities often lack the same health care infrastructure, and the nearest pharmacy may be hours away.
Our federal government itself relies heavily on the Postal Service to deliver medication to patients. The Department of Veteran’s Affairs provides 80 percent of outpatient prescriptions via mail-order pharmacy; a slowed system kneecaps the department’s ability to get medications to our nation’s veterans.
Mail service pharmacies can help to manage the costs of prescription drug benefits as a whole. As a result of high‐volume purchasing, mail service pharmacies are frequently able to secure lower prices for prescription drugs, and savings are passed on to the consumer. But a keystone of this operation is the very organization that was established to provide Americans with accessible and affordable mailing options. Weakening the USPS could raise costs that will echo to patients — how will health care delivery adapt? Will pharmacies, in turn, reroute shipping through private couriers to ensure patients get their medications, making health care more expensive for both the pharmacy and the consumer? If needing to use more expensive shipping services, the price of mail-order medications could become unaffordable and inaccessible for Americans who are already feeling financial strain during the pandemic.
Despite the Postmaster General’s recent announcement to suspend the scaling back of USPS services, we don’t know specifics of what will be reversed back to normal. We do know that suspending future changes to a system that lacks capacity now will not solve the issue, and patients don’t have the luxury of time.
Friday, Postmaster General Louis DeJoy appeared before a hearing held by the Senate Homeland Security and Governmental Affairs Committee; this week, the House Oversight Committee will conduct hearings with Postmaster DeJoy as well as Postal Service board of governors Chairman Robert M. Duncan to get to the bottom of these slowdowns. I hope that swift corrective action follows, protecting patients’ ability to receive their medications.
The USPS was designed to be a service for all Americans to rely on. While we share an appreciation for building more efficiency into mail delivery, that’s not what’s happened here, and these changes are harming our families and our health.
Susan A. Cantrell is the chief executive officer of the Academy of Managed Care Pharmacy.