Lost in the mail: USPS changes delays medication delivery

For a person living with HIV, consistently taking their medication is critical and lifesaving.

Mail-order pharmacies allow people to receive their medication in a timely, convenient manner. This has especially benefited those who are elderly, living in rural areas without a pharmacy, or need the option because of work or family obligations.

New changes to the U.S. Postal Service are jeopardizing the value and convenience of getting prescriptions by mail.

In 2019, almost 200,000 million drugs were sent by mail. Managed care plans, Medicare Part D, the Veterans Health Administration, commercial plans, and other private and government programs have all sent prescriptions by mail.

The coronavirus pandemic has increased the use of mail-order prescription services by approximately 21% as people with chronic health conditions (such as HIV), people with disabilities, or the elderly remain safe at home.

In May 2020, as the pandemic continued to rise, newly named Postmaster General Louis DeJoy issued changes to the Postal Service. The changes included reducing the amount of mail processing equipment across the country, removing mailboxes and preventing mail carriers from working overtime unless prior approval was received. Additionally, if a mail carrier’s route would delay their work for that day, they were ordered to leave the mail at the distribution center and deliver it the next day.

As a result of this, receipt of needed medications has been delayed. These delays have ranged from a few days to weeks in many cases.

Companies such UPS or FedEx could be an alternative, but generally these companies do not deliver in rural areas, or if they do, add an additional delivery change. The Postal Service is the less expensive and more accessible option for those living in the United States.

The delays occurring because of these changes and potential lack of alternatives for receiving medications could result in avoidable hospitalizations or death.

The Veterans Affairs health system has noted recent significant delays in veterans receiving their medications on time. Approximately 30,000 veterans were living with HIV nationwide according to 2018 government data. To date 80% of all veterans receive their medications by mail which includes those with HIV, while 20% of veterans pick up their medications at VA medical facilities. News reports have stated that some Veterans are experiencing up to two-week delays in getting their medication by mail delivery.

In 2016, according to the Centers for Disease Control and Prevention approximately 50% of those living with HIV were over the age of 50 with approximately 50% of seniors, receiving their medication through the mail as well. They are in a high-risk category if they do not receive their medication on time.

On Tuesday August 18, 2020, Postmaster DeJoy announced the suspension of the changes ordered in May until after the November 2020 presidential election. Part of the suspension includes no closures of mail processing facilities and overtime will continue as needed, but must be approved.

The key issue, however, is that he will not reverse changes already in place, such as replacing sorting machines and mailboxes that had been removed. However, in recent testimony, DeJoy denied ordering the removal of mail processing equipment but stated he will not have them reinstated because of costs. These unaddressed changes are crippling our postal service resulting in continued if not continuously escalating delays in mail service which endangers the health and welfare of those who depend on the postal service for obtaining their medications.

While the focus is on the 2020 presidential election and mail-in ballots, it is critical that the administration listen to patients and care providers regarding these life-endangering delays that can result in avoidable adverse outcomes.

The Postal Service needs the tools and funding from the government for support of the important service they provide to those who need access to their medications.