Programs that deliver maintenance medications for chronic diseases through the mail – commonly known as mail order or mail service pharmacies — can help manage widespread medication non-adherence, which negatively impacts patient illness and increases health care costs.

Research published by the American Journal of Managed Care in 2013 shows a positive association between mail-order pharmacy programs and improved adherence, especially for patients living with a chronic condition.

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Medication non-adherence is a frequent cause of preventable hospitalization and prolonged patient illness, costing the U.S. health care system $300 billion each year. Non-adherence occurs for many reasons — including patients' lack of understanding about how and when to take medications — but for some, accessing the pharmacy remains one of the biggest barriers to retrieving prescriptions. A lack of social support, time constraints and limited access to convenient transportation are commonly cited as reasons users cannot get their medication, according to the Centers for Disease Control and Prevention.

But it’s not just patients who have difficulty getting to the pharmacy who benefit from mail order pharmacies: These programs offer flexibility and time and cost-savings to all enrollees.

Cost. Many recurring prescriptions cost less when ordered through the mail. By offering increased day supplies of prescriptions for chronic conditions (e.g., 90-day prescriptions vs. 30-day prescriptions) and saving on costs typically associated with brick-and-mortar retail pharmacies, mail-order programs present cost-savings opportunities that can then be passed on to the consumer.

Convenience. Some mail order services will deliver maintenance medications through the mail, and also allow customers to pick up their prescription at a local pharmacy. Mail-order customers who use in-store pickup also receive the extended, 90-day maintenance medication prescriptions at the generally lower mail-order prices.

Customer service. With most mail-order programs, customers can make prescription refill requests online or by phone. Patients can have prescriptions automatically sent on the refill date, or have alerts dispatched via email, phone or text to remind them that a prescription is nearing the refill date. In many cases, mail-service customers can check their order online or by phone, and receive digital consumer health education about their medication and health condition.

Care quality. The American Journal of Managed Care report found that mail order pharmacy use is not associated with adverse events in most patients living with chronic illness. To the contrary, researchers said mail order programs could be associated with improved health outcomes. The data also suggests that efforts to increase the availability of mail order programs could be an important strategy for improving processes and outcomes of care for patients with chronic illness.

Maintenance Choice gives eligible CVS Caremark pharmacy benefit management plan members the option of picking up their 90-day maintenance prescriptions at CVS/pharmacy or receiving them through the mail. Regardless of which method the plan member selects, they pay the typically lower mail copay, while the plan sponsor receives the typically lower mail rate. Approximately 16 million CVS Caremark plan members were enrolled in Maintenance Choice as of late 2013.