As more and more Tri-Cities businesses urge their employees to purchase prescriptions online, local pharmacists say the trend will likely hurt independent small businesses the most and could lead to dangerous drug interaction for patients.
Eastman Chemical Co. spokeswoman Lisa Adams said Tuesday that starting in 2014, employees will be encouraged to purchase certain prescriptions, known as maintenance medications, over the Internet at a lower price than at brick-and-mortar pharmacies.
“This is part of a piece of our health care plan, which is focused on offering competitive benefits to our employees,” Adams said. “It reflects the continuing trend of our health and wellness programs to reduce costs and enable us to continue to offer affordable and competitive coverage.”
In an effort to reduce costs, and to avoid an excise tax on high-cost health care plans expected to be introduced in 2015 under the Affordable Care Act, Adams said the thousands of employees covered by the company’s in-house insurance plan, approximately 1,200 of which live in Washington County, will be offered incentives to buy some of their prescriptions online and will face higher charges at physical pharmacies.
The maintenance medications employees will be urged to purchase online include those for chronic conditions, like high blood pressure and cholesterol medications and diabetes supplies. Over-the-counter drugs, antibiotics, cold medicines and others used to treat acute conditions can be purchased at pharmacies without penalty, Adams said.
But Ahmed Atyia, a pharmacist at Val-U-Pharmacy on Johnson City’s Market Street, said the recent shift by companies urging their employees to purchase online medications steers revenue away from local small businesses.
“It’s not just Eastman, it seems like everybody’s doing it,” he said. “So many business are encouraging their employees to use mail-order companies, but it’s taking money out of the local economy and sending it to these companies in Florida and California when it should stay right here in Tennessee.”
“It would hurt any small pharmacy,” pharmacist Tracy Hart of Gray Pharmacy said. “Some of the chains have online and mail order pharmacies as part of their structures, so it wouldn’t hurt them as much, or it might even increase their business.”
What the pharmacists most opposed were the incentives offered to employees who make the switch to online medicines and the loss of patients’ access to expert consultation.
“It should be an even competition,” Atyia said. “I don’t mind the competition, but sometimes companies give incentives to the patients for using mail-order or drop the copay. If they come to our store, we have to charge that copay, so the patient really doesn’t have a choice.”
When purchasing medications over the Internet, Hart said patients may not be notified of possible drug interactions with other medicines or with certain foods.
“When people come into the pharmacy, we can help them to make sure they’re taking their medications correctly,” he said. “Some medications should not be taken with over-the-counter products or food supplements because it might make them ineffective. Depending on the medication, it can be dangerous to their health.”
The varying temperatures during a long ride from a distribution center to a patient’s home in the back of a delivery truck could affect other medications, Atyia said.
Adams said under Eastman’s plan, employees can consult with licensed pharmacists by phone about any side effects.
“This is something that has been around for a while, and home delivery pharmacies have the same guidelines to make sure the medications are delivered safely,” she said. “General and specialist pharmacists are available 24 hours a day to all the employees covered under this plan through a number they can call.”
She said the emphasis on online ordering for certain drugs doesn’t negate the need for local pharmacies, because acute and over-the-counter medications are usually needed immediately, and the new prescription plan doesn’t penalize employees for buying locally.
“It’s a trend that’s been around for a while,” she said. “There is a big push now to reduce the cost of health care, and this is one of the ways it’s being accomplished.”