House panel opposes forced use of mail order in Rx benefit plans

DES MOINES — An Iowa House committee has voted to prohibit companies that manage prescription drug benefit plans from forcing patients to get their medications through the mail.

Representative John Forbes of Urbandale, a pharmacist, said he often has to fix the problems when mail order companies fail.

“We had one patient have their insulin frozen that was mailed to them by mail order,” Forbes said. “Luckily, they found out it was frozen.”

Insulin cannot be used if it’s been frozen. Forbes said a month ago he had a patient bring in $3000 worth of pills they’d been mailed, but no longer needed.

“Mail orders say…they’re going to save money,” Forbes said. “…It doesn’t save money. They don’t call all the time and make sure that people really need those meds.”

Representative Brian Best, a Republican from Glidden, said he’s seen mail order company abuses, too.

“I owned a durable medical supply company and I saw companies that would sell tons of CPAP devices and you’d go to somebody’s closet and their closet was literally full of things they hadn’t used and I think with mail order, that can happen,” Best said.

Representative Shannon Lundgren, a Republican from Peosta, said a local pharmacist rather than a mail order company is often the better choice for the patient’s health.

“That face-to-face contact is of course extremely important when they’re dealing with extremely high dose or medication changes,” Lundgren said.

A representative of the state agency that manages Medicaid told lawmakers the state will likely have to spend more if mail order companies can’t be used for any of the medications prescribed to Medicaid patients.