As consumers get used to products being delivered to their homes, many community pharmacies are stepping up to deliver prescriptions to their patients. Providing a prescription delivery service helps meet a growing market demand for easy access and delivery of almost everything from groceries, takeout and household items to prescription drugs. A prescription delivery service not only helps pharmacies gain new patients, it can also help keep existing patients. some sources estimate that a prescription delivery service can help increase a pharmacy’s revenue by an average of 6-8%.
However, when providing a prescription drug delivery service, several things must be taken into account, such as how the drugs are packaged, workflow considerations, and regulatory issues (e.g., laws state/provincial, hipaa, etc.). Pharmacy technicians need to know the ins and outs of the prescription dispensing process to ensure patient expectations are met, medications are not compromised in transit, and pharmaceutical laws are followed.
How are prescriptions delivered to the patient’s home?
There are different methods of prescription delivery, such as by courier service, mail or drones.
courier service: Some pharmacies employ their own delivery drivers who make several trips a day to drop off prescriptions at patients’ homes, long-term care facilities, etc. Other pharmacies may contract with a third-party company that specializes in same-day delivery, such as shipt, iomni, scriptdrop, deliv rx, etc. when prescriptions are delivered by courier, they do not require extensive packaging as the prescription goes directly from the pharmacy to the patient’s home . Prescription drugs can also be delivered the same day ordered, as long as the order is placed before the cut-off time specified by the pharmacy.
Mail: Pharmacies can also get involved in mailing prescriptions using the United States Postal Service (USPS), Canada Post, UPS, FedEx, etc. Prescriptions that are shipped to the patient’s home will require more packaging, such as the use of a box with packing material instead of a bag, to protect the integrity of the medication as it will pass through multiple hands before reaching the patient. Prescriptions will also generally take longer to reach the patient as they must go through processing and sorting by the package delivery company.
Drones: Some pharmacy chains are beginning to deliver a patient’s medication to their home using a drone. A drone is an aerial vehicle that is remotely operated by a user using a GPS tracking system. drone-delivered packages are slowly lowered using a cable. this remains a promising delivery method, but will continue to expand in the future.
What are the advantages of delivering medications to the patient’s home?
As mentioned above, some pharmacies may see the benefits of a prescription delivery service through increased revenue, winning new patients who might not otherwise come to the pharmacy location, and improving relationships with existing patients. .
In addition, the convenience offered by prescription delivery can help improve adherence. Medication adherence is important for a variety of reasons, the most important being the health of the patient. but it’s also important for pharmacies and payers who are focused on improving star ratings and other quality measures around adherence.
filling prescriptions also helps prioritize the time you spend at the pharmacy. when patients choose to have their prescriptions delivered, this saves time at the pick-up counter. however, it remains important that patients who are filled with prescriptions know that the pharmacist is available to provide advice or, if appropriate under state/provincial law, that the pharmacist contacts them for required advice. It is also important that these patients receive information about the medication being administered to them, such as patient education brochures, patient information from the manufacturer, medical guides, etc.
Keep in mind that prescription delivery isn’t just about convenience. in some cases, patients may rely on home delivery of prescriptions to obtain necessary medications that they may not otherwise be able to obtain in a timely manner; for example, patients with limited mobility, busy lifestyles, lack of transportation, or patients living in rural areas who do not have a pharmacy nearby.
How should I pack the medications for delivery?
In general, medications delivered by courier should be packaged in a plain, non-transparent bag (such as a brown bag) with only the patient’s name and address on the outside of the bag. it is important that the outer bag or package hides which medication is being administered from the view of others. Similarly, medications to be shipped should be placed in plain packaging so that the contents cannot be identified. Shipped medications may also require padding or padding (eg, bubble wrap, packing peanuts, etc.) to prevent damage in transit. Please seal or write “Fragile” on the package, to prevent tablets or glass vials from breaking during transit.
When preparing liquids for delivery, you’ll want to take steps to prevent leaks and spills. Some examples of things you can do to prevent leaks and spills include making sure the lid is sealed tightly, putting waterproof tape around the lid, packing the liquid in plastic zip-lock bags (for example, ziploc storage bags, etc.), use enough padding material to eliminate slack and prevent product from tipping over, and stamp or write “this side up” and “fragile” on package to help prevent liquid from tipping or tampering incorrectly.
If your pharmacy delivers or ships refrigerated medications, you’ll want to make sure they’re packaged to maintain the “cold chain.” cold chain refers to a system for storing and transporting medicines at recommended temperatures from the point of manufacture to the point of use. this helps maintain the potency of the drug. If your pharmacy delivers or mails refrigerated medications, it is very important to follow your pharmacy’s packaging policy to help ensure the cold chain is maintained. this may include placing items in a plastic bag to prevent condensation, shipping with cooler packs, placing temperature control devices on the package, and using express delivery to avoid shipping delays.
What regulatory issues should I be aware of when submitting prescriptions for delivery?
double check the address the prescription is being sent to. if it’s an out-of-state address, you’ll want to make sure you’re legally able to deliver or ship the medication. Some states or provinces may not allow medications to be shipped to an out-of-state/province address without applying for a mail-order pharmacy license. also be alert for p.o. mailbox addresses when shipping prescriptions that require a patient signature to be captured by the delivery person. emails. boxes are not acceptable addresses in these cases as no one will be available to physically receive the package.
Include all documentation, such as HIPAA privacy notices, medical guides, patient information sheets, or any state-specific notices. For example, in Texas, prescriptions delivered to a patient’s home must include written information that would otherwise be given orally, along with a specific statement directing the patient to read the information provided before taking the medication and that call the pharmacy if you have any questions.
Please note that the United States Postal Service has regulations regarding the shipment of controlled substances. Licensed pharmacies may mail prescription controlled substances, as long as they are labeled in accordance with federal and state regulations. As mentioned above, prescriptions for controlled substances must be placed in a plain outer package that is free of markings that may indicate the nature of the contents.
If your pharmacy delivers durable medical equipment (eg, diabetic testing supplies, nebulizers, etc.) that has been billed to Medicare, there are a few things you should be aware of. For Medicare-billed durable medical equipment delivered by courier service, the date of delivery should be used as the date of service on the claim (not the date of pharmacy fill). the patient or their designee must sign for the item on the delivery date. for supplies shipped by mail, the date of shipment will be the date of service on the claim.
What are some workflow considerations with prescription delivery?
Staying organized with your pharmacy workflow will help expedite prescription delivery. Pharmacies that provide prescription delivery must have a process to mark these prescriptions and ensure that they are categorized separately from prescriptions to be picked up at the pharmacy. Clearly indicating on the healthcare bag that the Rx is for delivery, using different colored baskets, and marking patient profiles are examples of how some pharmacies do this. Be sure to prioritize these recipes appropriately and dedicate a special place to store prescriptions that need to be delivered or mailed.
If there are specific delivery times or cut-off times for mail order, you’ll want to make sure those times are clearly posted for everyone to see at the pharmacy. As delivery orders come in, try to ensure they are processed and shipped at the next closest scheduled delivery time. If something has to be shipped later than the patient may be anticipating, be sure to communicate with the patient to reset expectations. Also, let patients know as soon as possible if there are any problems with insurance coverage or if there are problems getting the medication.
For prescriptions that will be mailed to a patient, assign one person each day to handle packaging and labeling for shipping. There should be a specified cut-off time, provided by the package delivery company (eg, USPS, FedEx, etc.), for when packages are due to go out for next-day, two-day, etc. shipping times. all packages due to go out that day must be ready to ship before the deadline.
For more details on how to incorporate prescription drug delivery and other services into your pharmacy workflow, check out our technician tutorial on optimizing your pharmacy workflow.
What prescription delivery best practices should I follow?
Inform patients in advance if prescriptions to be delivered to their home will require a signature, such as most courier services and some mail-order medications, depending on pharmacy policies or laws local. In these cases, it will be necessary for someone to be at home, otherwise the medicine cannot be delivered. Also let patients know in advance if there is a charge for medication delivery so they are not caught off guard. Providing patients with clear information about what to expect with prescription delivery will help avoid delays, the need to reschedule deliveries, and customer service issues.
If available, sign up patients for text or email notifications so they are alerted when the shipped medication has been delivered to their home. If mail-order prescriptions will not require a person to receive the package, it is important that patients are notified of deliveries. this way, they can quickly bring the recipe into a temperature-controlled environment. this is especially important during the winter and summer months when temperature extremes are more likely and with medications that require refrigeration.
When enrolling a patient in prescription delivery, you’ll want to be sure to confirm their desired mailing address and collect their payment information in accordance with your company’s policy. Before sending any medication for delivery, you may want to call the patient to confirm their address and payment information, especially if this is the first time something has been delivered or it has been a while since you received something. consider confirming expensive medications with patients as well. for example, your pharmacy may want to set a certain dollar amount to contact the patient for confirmation, such as $50, $100, etc. watch for prescription refills that go up in price from the previous fill and confirm that the patient is aware of the price difference before submitting. State and provincial laws may vary, but generally, once a prescription leaves the possession of the pharmacy or delivery person, it cannot be returned to inventory. You don’t want to put your pharmacy in a situation where a patient is reimbursed for an expensive drug that can’t be reused.
As with all other prescription medications, be sure to avoid HIPAA violations by making sure the delivery package includes medication for that patient only. if the wrong medication is delivered or sent to the wrong patient, the convenience of prescription delivery is eliminated, as the patient will have to return the package. And the pharmacist will have to follow your pharmacy’s policies and procedures for documenting and reporting HIPAA violations, which takes time away from other pharmacy operations. Unfortunately, pharmacies have been fined because the wrong patient’s medication was dispensed.
Know which medications your pharmacy policy does not allow to be delivered or mailed. for example, some pharmacies may choose not to deliver controlled substances (oxycodone [oxycontin (us), oxyneo (canada), etc.], morphine [kadian, ms contin, etc.]), refrigerated medications (insulin, etc. .) or medicines that require reconstitution (antibiotic suspensions, etc.). Also, your pharmacy may restrict mail-order medications that cannot be shaken. For example, shaking epoetin alfa (Procrit [US], Eprex [Canada]) can cause the medication to foam and ruin you.
If your pharmacy allows patients to add other over-the-counter (OTC) items to their deliveries, ask the pharmacist to verify that these items do not interact with the patient’s prescriptions or medical conditions. For example, ibuprofen (advil, motrin, etc) can be a problem for patients taking blood thinners (warfarin, dabigatran, etc), as both medications can cause bleeding.
Stay organized with delivery-related documentation. for example, assign one person to be responsible each day for organizing and filing proof of delivery documentation if they are not captured electronically. keep separate files and folders for other documents, such as tracking numbers for shipped prescriptions, delivery confirmations, etc. you’ll want to easily access this information if a patient inquires about the status of their mail-in prescription.
project leader in the preparation of this technical tutorial (360180): flora harp, pharmd/editor assistant
cite this document as follows: technical tutorial, delivery and delivery of prescriptions. letter from the pharmacist/letter from the pharmacy technician. January 2020.
─continue for a “cheat sheet” summary on prescription delivery and shipping─
“cheat sheet” for delivering and mailing prescriptions
What methods are used to deliver a prescription to a patient’s home?
The most common methods are via courier or mail delivery. the courier service includes delivery drivers who are employees of the pharmacy or subcontracted through an outside company. courier delivery allows the prescription to go directly from the pharmacy to the patient’s home. This can be contrasted with shipping medications by mail (eg, United States Postal Service, Canada Post, UPS, FedEx, etc.). With this method, the prescription passes through multiple hands and generally takes longer to reach the patient than with the courier service.
what are some of the benefits of prescription delivery?
- increased income for the pharmacy
- attraction of new patients
- improved relationships with current patients
- better adherence to the medication
- timely access to prescriptions for patients who have difficulty visiting the pharmacy
How should medications be packaged for delivery?
In general, medications should be packaged in a plain outer package that conceals what’s inside. shipped medications may require additional padding or padding to prevent damage during transit. Liquids must be packaged to prevent spills and leaks. this includes putting waterproof tape around the lid, double-bagging the container in zip-lock plastic bags, etc. refrigerated medications must be packaged to maintain the cold chain, which may include the use of cooler bags, temperature control devices, and express shipping. All required documentation must be included in the package being sent for delivery (hipaa privacy notices, patient information sheets, medical guides, state specific notices, etc.).
What best practices should I follow to ensure the success of my pharmacy’s prescription delivery service?
- Let patients know if prescriptions will need to be signed and when they will be delivered to avoid delays.
- When available, sign patients up for text or email notifications to Receive an alert when medications have been shipped. delivered, otherwise a signature will be required.
- Know and use your pharmacy’s method of marking and arranging for delivery of prescriptions.
- Be aware of medications that your pharmacy policy does not allow to be delivered or mailed.
- Watch for medications out of state/province or p.o. box addresses; delivery may not be allowed in some cases.
- Confirm that patients want expensive medications before sending them for delivery.
- Triple-check to ensure that packages of delivery include prescriptions for the intended patient only.
- Have the pharmacist check other items that were added to deliveries to make sure there are no drug interactions or medical conditions.
- ensure delivery orders are processed and shipped at the next closest delivery time.
- reset patient expectations if there is a delivery delay.
- assign one person each day to be responsible for packaging and labeling prescriptions that need to be mailed.
- stay organized with paperwork related to delivery.
[January 2020; 360180]