Some startups grapple with USPS delays in medication delivery

In the last month, more of Simple Health’s patients began asking, “Where’s my package?”

The New York-based startup lets users get a birth control prescription through a virtual consultation, and offers at-home delivery. But lately it, and other health startups that conduct much of their business through the mail, have noticed some medications aren’t making it to customers’ doorsteps on time.

“It’s just bubbling up as we speak,” CEO Carrie SiuButt said in a phone interview.

Recent cost-cutting measures at the U.S. Postal Service, including removing mail collection boxes and eliminating overtime for mail carriers, have led to a slowdown in mail delivery in some locations. The Washington Post first reported that the USPS had warned several states that it could not guarantee all ballots cast by mail for the November election would arrive in time to be counted. These changes also have consequences for patients’ ability to receive their prescriptions via the mail.

Last year, USPS delivered 1.2 billion prescriptions, according to the American Postal Workers Union. For startups that primarily use USPS for delivery, such as Simple Health, they’re left to sort through the consequences.

While Simple Health hasn’t seen many customer complaints, slowdowns in the mail have still affected its business. The startup had to send out replacements for some shipments, and timely delivery is especially important for some medications, such as the birth control ring, which must be refrigerated.

“Everything is just backed up,” SiuButt said. “Basically, this whole thing is messing up how fast we’re able to get shipments to our customers. … We’re trying to get a business continuity plan put in place to make sure we can still deliver.”

 

Mixed reports 

Other companies have seen some turbulence from the changes. Everlywell, which sends users a number of common at-home tests via mail, also uses USPS as its default mail carrier.

“Generally, things have been running smoothly but there have been some delays, often based on region. We’ve advised our customers that the mail may take a little longer than usual and to plan accordingly,” Christina Song, Everlywell’s communications director, wrote in an email.

For at-home Covid-19 tests, Everlywell uses UPS to overnight samples to its partner labs, she added.

Nurx, which also provides home delivery of birth control pills, said nearly all of its patients received their medication on time. But the startup is still offering them the option to pick up their prescription from their local pharmacy.

Truepill, which provides pharmacy fulfillment services for a number of startups, including Nurx, Simple Health, and Hims & Hers, said it was monitoring the situation. Most of its customers use USPS for shipping, given its lower cost and wide reach, but some opt to use FedEx or UPS for time-sensitive or expensive medications,  CEO Umar Afridi wrote in an email.

“Currently, we are not experiencing notable shipping delays with USPS, though we have seen a few service-level disruptions, including pickups, not happening on time,” he wrote.

He added that some of Truepill’s customers have inquired about carrier alternatives, but none of them have formalized a change in carriers.

 

Concerned patients

Patients, worried about receiving their prescriptions late, have also been looking at their options. After reviewing the tracking information for a late prescription, Jennifer Hudson said she found her medication was sitting at a distribution center in Texas for 11 days before it finally made its way to her local post office. Normally, she gets her prescription within four to five days.

Another woman, who wished to remain anonymous, said she had looked into getting her prescriptions sent early, but couldn’t order them earlier than the refill date.  Her husband also gets his inhaler, used to manage COPD, in the mail.

“We have no pharmacy in our town. They closed a few years ago. Hubby and I are both high risk,” she wrote in an email. “I even get meds through the mail for my dog. She is nearly 16. Without her Galliprant, she can’t walk at all!”

Hundreds of veterans have raised concerns about prescription delays, a group of Democratic senators said. According to the Associated Press, the VA fills roughly 80% of veterans’ prescriptions by mail.

So far, the three largest pharmacy benefit managers — CVS Health, Express Scripts and OptumRx  — haven’t had much to say about what’s happening at the post office. They all use USPS to ship medications, and in some cases, patients are incentivized or required to get their prescriptions through a mail-order pharmacy.

An Express Scripts spokesperson said the company wasn’t currently experiencing any unusual delays in deliveries, and OptumRx said it continually monitors shipments and makes adjustments as needed.

Online pharmacy PillPack, which was acquired by Amazon, said it was monitoring for delays and communicating with carriers.

“We adjust the carriers we use to ship medications based on available information,” a company spokesperson wrote in an email.

 

Suspending the changes

USPS has acknowledged “temporary service disruptions in a few locations domestically,” which it said were due to the Covid-19 pandemic.

“Things are slowly getting back to normal, however until we reach pre-Covid conditions, we continue to leverage our available resources to match the increased workload, including hiring based on local needs,” Kim Frum, a senior public relations representative for USPS, wrote in an email.

Yesterday, Postmaster Louis DeJoy said USPS would suspend some of the recent initiatives until the election is over. He specified that mail processing equipment and collection boxes would remain in place, overtime would continue to be approved, and post office hours would not change.

But after meeting with DeJoy on Wednesday, Speaker of the House Nancy Pelosi said that wasn’t entirely true.

“The Postmaster General frankly admitted that he had no intention of replacing the sorting machines, blue mailboxes and other key mail infrastructure that have been removed and that plans for adequate overtime, which is critical for the timely delivery of mail, are not in the works,” she said in a statement.

DeJoy will testify before the Senate Homeland Security and Governmental Affairs Committee on Friday and the House Oversight Committee next week. In the meantime, patients will be waiting for their mail.

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