August 22, 2011 
For my purposes, I’m going to define a preferred pharmacy as one of the following:
- Mail order pharmacy
- 90-day network (e.g., Maintenance Choice, Walgreens90)
- Limited or tiered retail network (e.g., Align, Walmart, Caterpillar, Humana/Walmart)
- Specialty pharmacy
- Specialty pharmacy with exclusive distribution of a drug
This is the first of three posts on new ideas for increasing usage:
- Driving preferred pharmacy usage from the employer site
- Using social media
- Borrowing from other industries
For today’s post, I’m going to focus on how a PBM (or retailer) could work with an employer to drive use of a preferred pharmacy. There are the obvious ways:
- Plan design
- Incentives
- Interventions (letters, calls)
- Reminders on the intranet
But, let’s look at a little history of what’s been tried first outside the obvious:
- On-site collection boxes
- Kiosks
- On-site pharmacy
It’s my understanding that Medco used to (or maybe still does) have “drop boxes” at their large employer sites in the HR department for people to drop off prescriptions for mail order. The employee would drop them off and then they would be FedEx’d to Medco each night. It’s a nice convenience feature and if promoted probably serves as a good constant reminder.
Another attempt was made by Duane Reade in NY to put kiosks at employer sites and hospitals to capture new prescriptions and allow them to be couriered over to the consumer from their central fill. It was a good idea, but it didn’t scale well and had limited upside outside NY.
I spent about a year looking at how to blend the Duane Reade model with Redbox to allow for kiosks that could leverage telemedicine and dispense the top 100 SKUs. A few models of that concept have continued to grow (although slowly). Instymeds now has 200 deployments (after almost a decade). I’ve heard about a few others continuing to try also.
You then began to see a spike in on-site clinics where you could see a physician or another medical professional and get a prescription filled. Again, this works like some of these others in high density areas where there is a population using lots of chronic medications and with the same PBM/insurer.
Now, with technology, is there an easier way?
Why not have a QR Code posted in your HR department or in the physician’s office or on the back of your ID card or some other place. When the patient gets their new Rx, they can scan in the code and it can do any of the following:
- Show them a message about considering mail order
- Trigger an SMS asking someone to call them
- Send an e-mail requesting a call back about the closest preferred pharmacy
- Send them a map of the closest in-network pharmacy
- Link them to a YouTube video on getting started with mail order
- Or, in the Worker’s Compensation area, it could create a virtual card for the network
We all know that mobile apps in the pharmacy space are “all the rage” although adoption is surely in the 5-10% range (best case). So, will this make a difference? Perhaps not today, but it’s a low-cost way of learning about how consumers (especially those working in large, high-tech environments) might engage. Right now, most companies are in a learning mode.
Enabling Healthy Decisions 
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