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VA problems raise worries about mail slowdown, prescriptions

VA problems raise worries about mail slowdown, prescriptions
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Concern is growing among Democrats and advocacy groups that slowdowns in the mail could leave millions of people without access to needed medications. 

The Department of Veterans Affairs (VA), which fills about 80 percent of prescriptions by mail, has already reported problems, and has been forced to use alternative methods of shipping prescriptions in certain areas of the country.

While only about 5 percent of all prescription drugs are delivered in the mail, pharmacies and pharmacy benefit managers are increasingly using the mail to fill prescriptions for the most expensive drugs.

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The coronavirus pandemic has likely increased those numbers, as people opt for a safer option than visiting pharmacies in person.

The Postal Service is a critical part of the pharmacy distribution system, and a delivery delay could be catastrophic for patients. 

“My patients who rely on their insulin, or their inhalers, or any other type of medication can’t wait weeks to see whether or not their prescription will be delivered,” Jacqueline Fincher, president of the American College of Physicians, said in a statement.

“Any prescription medication can only be as effective as a patient’s ability to access it. We need to ensure that patients can continue to rely on the U.S. Postal Service to receive their critical medications,” Fincher said.

Democrats are using that concern to hammer the Trump administration's handling of the Postal Service. 

“Now [Trump] is putting the lives of Nevada’s seniors at risk by trying to defund the post office,” Sen. Catherine Cortez MastoCatherine Marie Cortez MastoFavorites emerge as Latino leaders press Biden to appoint 5 Hispanics to Cabinet Senate Democrats reelect Schumer as leader by acclamation  McConnell, Graham warn GOP Senate majority on the line in Georgia MORE (D-Nev.) said in her Democratic National Convention address Monday. “Here’s what that means: They won’t be able to get their prescriptions, because he wants to win an election.”

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In the House, the Energy and Commerce Committee this week launched an investigation into how the Postal Service’s organizational and operational changes are impacting the delivery of prescription drugs.

According to the committee, 1.2 billion prescriptions were delivered through the Postal Service in 2019.

While there are anecdotal stories of people's medication being delayed, major pharmacies and pharmacy groups said they have not yet been impacted.

A Rite Aid spokesman said the company “uses multiple vendor delivery partners and we are not experiencing delays.”

An ExpressScripts spokeswoman also said the company was “not currently experiencing any unusual delays in deliveries.”

A CVS spokesman said the company is “closely monitoring the current situation,” and will “continue to do everything in our power to ensure deliveries are made on time.”

OptumRx, which primarily uses the Postal Service to fill its 500 million mail-order prescriptions a year, said it will “make adjustments as needed.”

B. Douglas Hoey, CEO of the National Community Pharmacists Association, said community pharmacies have not seen any recent increases in people coming into the pharmacies for emergency prescriptions due to a delayed mail order.

“There has not been an avalanche of complaints ... over the last month or so,” Hoey said.

Hoey said mail order prescriptions have been unpredictable since before the post office said they were going to be making changes.

“At this point it probably is more of a political issue,” he said.

Concerns over postal delays stem from changes instituted by Postmaster General Louis DeJoyLouis DeJoyJudge orders Postal Service to sweep facilities twice a day for any ballots that can be delivered on time Brent Budowsky: Democracy in America is on trial Postal Service misses court-ordered deadline for unsent mail ballots MORE, a longtime supporter and fundraiser for President TrumpDonald John TrumpMinnesota certifies Biden victory Trump tells allies he plans to pardon Michael Flynn: report Republican John James concedes in Michigan Senate race MORE, who took over the role in June.

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DeJoy reversed course Tuesday, saying that all changes being made to the Postal Service would be paused until after the Nov.3 election. 

However, Speaker Nancy PelosiNancy PelosiSpending deal clears obstacle in shutdown fight Ocasio-Cortez, Cruz trade jabs over COVID-19 relief: People 'going hungry as you tweet from' vacation Rep. Rick Allen tests positive for COVID-19 MORE (D-Calif.) on Wednesday said DeJoy does not intend to roll back any of the changes he has already instituted.

Trump said he would block emergency funding to the financially gutted agency, while acknowledging that it needs the money in order to function properly.

While the changes may impact the delivery of ballots in November, it is already taking a toll on veterans. According to the group Disabled American Veterans, medications from the VA have been delayed by an average of 25 percent over the past year.

In an email to the organization reviewed by The Hill, VA officials said they detected “hot spots” with delivery delays in Detroit as well as parts of New York and New Jersey, and “proactively converted from USPS to United Parcel Service (UPS) 2nd day air for those areas until service levels could be returned.”

The agency said it also identified a delivery service issue with UPS in the Arizona area and converted to FedEx for roughly five weeks until service levels were restored with UPS. 

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“It is simply unacceptable that America’s veterans, particularly those who were injured or made ill in defense of this country, should face the prospect of not receiving necessary medications in a timely manner considering such delays can be the difference between health and sickness, or even worse,” Disabled American Veterans National Commander Stephen Whitehead said in a statement.  

VA spokesperson Christina Noel said the agency “has always used a variety of prescription delivery methods to ensure timely delivery, including in-person pharmacies, USPS, and commercial carriers.”

Prescriptions delivered through the Postal Service “are averaging less than three days delivery time,” Noel said. The VA website offers assurances that prescriptions typically arrive within three to five days.

But Whitehead said the concern was about more than just prescriptions. 

“Millions of veterans also rely on the post office to deliver claims decisions, hearing notifications and other critical messages from the VA, all of which must be timely to ensure veterans receive the benefits they have earned through their service and sacrifice,” Whitehead said.