Years ago, it would be difficult to imagine all that we can now do at the press of a button. Do you need a ride? Call a Lyft. Do you need groceries? Order from Instacart. Do you need your prescriptions today? Order from Capsule. Or Alto. Or if you have a few days, you can get home delivery from companies like Amazon Pharmacy, GoodRx, or Mark Cuban Cost Plus Drug Company (the latter two are currently supported by Truepill's pharmacy fulfillment infrastructure, by the way).
Given the shift that Americans have made to online shopping over the past decade, mail-order pharmacy seems like a shoe-in for success. Yet, from 2010 to 2020, mail order pharmacies' rate of 30-day equivalent prescriptions shrank by 22%.
Still, venture capitalists are investing large sums of money in digital pharmacies. To some, it seems like the pharmacy sector is ripe for a herd of unicorns—organizations like GoodRx that disrupt the traditional flow of money and drug product and generate billions in earnings. The growing interest in digital pharmacies has led us to wonder: will digital pharmacies become the new normal, leading to widescale disruption across the pharmaceutical sector? Or are they another investing fad?
Mar. 10: Pharmacy's role in everywhere care
3 features that may project the path forward for digital pharmacies
When trying to answer these questions, it's unclear whether digital pharmacies will be able to differentiate themselves from existing mail order pharmacies and re-define patient expectations around pharmacy services.
Digital pharmacies seem to be at a crossroads. Either the companies will follow the same path as mail-order—creating a profitable niche that does not really disrupt the traditional pharmacy marketplace—or they will carve a new path forward, pushing pharmacy stakeholders toward more competitive, "consumer-first" practices.
Digital pharmacies will need to provide three key features to truly have a chance at impacting the broader marketplace. Tracking their progress toward achieving these goals will help industry watchers better anticipate whether any of the new models will truly be a disruptor.
- Responsive patient experience: For every patient who finds ordering medication on an app to be more efficient than walking into a pharmacy, there will be another who finds the technology and lack of perceived human connection frustrating. This is especially the case when patients have questions, concerns, or need to modify prescription details, such as changing delivery date or address. Responsiveness is an area that traditional mail-order pharmacies have struggled. Digital pharmacies that can prove themselves to be user-friendly, efficient, and accessible may have an advantage over their mail-order counterparts as well as brick-and-mortar locations.
- Disruptive pricing strategies: Complaints against high drug costs have swelled over the past few years, and patients most often come face-to-face with these prices at the pharmacy counter. Even patients with health insurance often experience high medication costs via pre-deductible expenses, copays, and co-insurance. Some digital pharmacies are attempting to help patients access lower cost drugs. For example, GoodRx and Marc Cuban's Cost Plus Drug offer medications directly to consumers at discounted rates that circumvent the traditional insurance benefit. Other digital pharmacies advertise their ability to access and apply manufacturer-sponsored coupons and discounts to lower patient out-of-pocket costs.
- Improved patient outcomes: According to OptumRx and Express Scripts, home delivery of medications can reduce gaps in therapy and increase performance on medication adherence metrics, a common measure of care quality. This is likely linked to automatic refill options and the move towards 90-day prescriptions. Other digital pharmacies, especially those coupled with telehealth provider visits and diagnostics, may track additional outcomes metrics such as whether patients are seeing improvement in their health conditions. Proven outcomes may incentivize pharmacy benefit plans to take further steps to incentivize use of digital pharmacy services.
Digital pharmacy's golden ticket? Staying true to the legacy of accessible, holistic pharmacy care
Digital pharmacies may be uniquely able to disrupt the retail pharmacy market, but their ability to succeed is closely linked to their ability to remember one key detail: health care, above all else, is personal.
Many brick-and-mortar pharmacies, often thought to be a key community touchpoint for health care, are struggling. Independent pharmacies are increasingly being acquired by large chains, and some are then closed. Pharmacists at chain pharmacies are quitting their retail pharmacy positions over concern that their hectic schedules may lead to harmful mistakes.
As the lines at brick-and-mortar locations grow longer and pharmacists' access to patients shrinks, digital pharmacies can position themselves as the solution. However, their success will depend on their ability to uphold the legacy of pharmacy industry by providing holistic, comprehensive care to patients.
Site of care shifts are helping make patient care more accessible, convenient, and low-cost. But the lack of an ecosystem-wide strategy for the shift to “everywhere care” could lead to missed opportunities or unintended consequences as a wide range of outpatient, virtual, and home-based care solutions fragment care delivery across many sites, “owners,” and touchpoints.