The frustrations for retailers of dealing with mail order extend beyond disappearing customers and differential pricing. There's the question of how to deal with patients who come in for just enough medication to tide them over until the mail carrier arrives.
The supermarket pharmacist has to decide how much to charge for a two-days' supply, says Russell Fair, vice president of Giant Food, Landover, Md., which does not offer mail order, and whether to try and persuade the patient to return to the advantages of retail pharmacy. And then suppose the patient doesn't have a prescription, as is likely, Fair continues. Now the pharmacist has to take the time and trouble to contact the prescriber -- all for a patient who is not even a customer.
"And then this same patient, for whom you've just gotten a short-term supply of his medicine to tide him over, will complain about how much higher the price is you're charging compared to mail order," adds Chuck Weiss, director of pharmacy operations at Fred W. Albrecht Grocery Co., Akron, Ohio, not realizing that differential pricing, as practiced by the drug manufacturers, is responsible.
"Because the drug manufacturers offer discounts to mail order that no retail operation can get, irrespective of purchasing volumes, the retail customer must pay a higher price to subsidize the lower price paid by the mail-order customer. That hurts the consumer, it hurts the retail pharmacy, and it's very unfair," says Weiss.
When mail-order pharmacy customers return to his stores because they are experiencing "some problems," Jeff Maltese, director of pharmacy at Foodarama Supermarkets, Freehold, N.J., says he can barely resist saying, "I told you so."
"Some of the third-party plans make the mail-order option so financially appealing that beneficiaries simply have to select it," he says. "When you can get a 90-days' supply for no copay, vs. only a 30-days' supply at retail for a $10 copay, it's hard to resist the mail.
"But then there's some crisis: The medicine stops working or there's some interaction. That's when the patient comes back to the store, because he needs to talk with the pharmacist. It's on such occasions that you can make some converts. People realize what they gave up, in terms of service and pharmacological expertise, when they switched from retail to mail in order to save a few dollars.
"What we in supermarket pharmacy have to do is emphasize those strengths; that is, service and expertise and accessibility," says Maltese. "That's where we can compete against mail order. But on price, forget it. Not until differential pricing is a thing of the past."
The most irksome thing about mail order, says Grant MacLean, pharmacy buyer/merchandiser at Rosauers Supermarkets, Spokane, Wash., is the damage it can inflict upon the perceived value of pharmacist-patient face-to-face interaction.
"Pharmacy is about more than the drug alone," MacLean says. "It's about pharmaceutical services. It's about applying the expertise of a health care professional. But what mail order builds up in the patient's mind is that the only thing pharmacy is about is getting you the drug. The more that perception gains ground, the poorer will be the health care for Americans."
