A new study comparing utilization rates of patients filling 90-day prescription medications using community and mail order pharmacies found that when copays are similar, patients preferred the community pharmacy channel by a ratio of four to one.

“When you look at some of the trends today, I think what we’re seeing is a slowdown and flattening of mail penetration,” says Gerry Gleeson, divisional vice president for bio-pharmaceutical development and market access at Walgreens, which conducted the study. “While mail has had a level of effectiveness in terms of costs savings, there are alternative options that are cost-effective in the marketplace today.”

In an earlier study released in February, Walgreens data showed a 15% increase in medication adherence through a 90-day retail option compared to 30-day retail option, which is “very significant,” says Gleeson. “When we do other types of adherence programs — telephonic or letter-writing programs  — we see single-digit increases in adherence. When we see a 15% increase overall, that’s a pretty sizeable rate.”

In 2011, medication nonadherence cost the U.S. health care system $317.4 billion in treating medical complications that could have been avoided if patents had taken their medication as prescribed, according to Express Scripts. The PBM recently released its 2011 Drug Trend Report, which shows that, for many therapy classes, less than 50% of patients take their medication as prescribed.

In addition to patients’ preference for face-to-face interactions at community pharmacies, the Walgreens study — published in the April issue of Journal of Managed Care Pharmacy — showed there was no significant difference between the employer’s cost per prescription for 90-day maintenance medications in either channel.

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