JEFFERSONVILLE - “No one's coming through the door,” said Maria Neumann. She's the owner of Jeff Pharmacy and she's speaking about customers getting their prescriptions through the mail, rather than going to pick them up at the pharmacy.

While anyone can sign up for mail order prescriptions at their discretion, local school staff and retirees received a letter in the mail in March informing them that they must get maintenance prescriptions through mail order (that's medicines to treat long-term chronic health conditions such as high blood pressure, cholesterol and diabetes).

The letter came from Dutchess Educational Health Insurance Consortium (DEHIC), an agency that coordinates group health insurance plans. Its plans are through Empire Blue Cross/Blue Shield and they service local school districts including Sullivan West, Sullivan County BOCES, Fallsburg, Liberty, Livingston Manor and Roscoe. The mail-order prescription program is managed through the company Express Scripts.

The change went into effect on July 1, but Neumann said some of her customers made the switch even earlier when they received the letter in March. Although she's not sure of the numbers yet, she estimates a 25-35 percent loss in business. “It will hurt the local economy,” she said.

DEHIC says getting prescriptions through mail order saves on time and cost. Customers get free standard shipping and refill reminders, and can set up automatic refills. It doesn't cost anything to switch to home delivery and customers can sign up online or by calling.

Susan Savas, a consultant to DEHIC, said that the board of trustees was undertaking different initiatives to lower costs for its 25 member organizations. One of those initiatives is the mail order prescription program. Savas said it will be the least impactful program to initiate, and it will save $2.2 million.

However, in addition to hurting business, Neumann said customers have other concerns about getting prescriptions through the mail. For instance, will the package be protected from weather elements, and if no one is home will the package sit outside exposed to harsh heat or snow and rain.

Neumann said customers will also lose the one-on-one communication they get with a pharmacist any time they visit a pharmacy. They are able to ask questions and receive specific information.

In the mail order program, customers will have access to Express Scripts pharmacists by phone 24 hours a day, seven days a week. Most medications can come in a 90-day supply, rather than a 30-day supply from the pharmacy, which saves on copays and lowers costs. Also, a study has shown that patients are less likely to miss a dose and more likely to take it the way the doctor prescribed when medicine is sent to one's home, and there is a higher accuracy rate that you are getting the right medicine.

Ed Chellis is a retired teacher and assistant superintendent of Delaware Valley School, where he worked for 30 years. He is one of the people who got that letter in the mail in March. “A lot of us are upset because we like to have our local drug store,” Chellis said. He continued, “In the middle of the night you can call them and they'll meet you there. That's not going to happen with mail order.”

While prescriptions make up a large part of the business, without the foot traffic of people coming into the store, sales of other items such as over-the-counter medications, glasses and toiletries will go down. Not only that, Neumann said many people who come to the pharmacy like to go next door to Ted's Restaurant to enjoy a meal, and that business may be impacted also.

When Neumann heard about this change (the health insurance company didn't contact her; she was informed by a customer) she wanted to see if there was anything she could do. She found out that there is a contract that would allow people to still use the pharmacy. She signed that contract and the health insurance company said it will go into effect soon.

Savas confirmed that pharmacies can sign a contract with Express Scripts that allows customers to opt-out of the mail order program. She said three pharmacies in Dutchess County have already done so.

NYS Assemblywoman Aileen Gunther is also alarmed about this issue. She said her office has received many phone calls from concerned citizens. As a nurse, she understands the importance of communication with your pharmacist. “All of our local pharmacists not only give them their prescriptions, but also teach them. I think that's an important part,” Gunther said.

She said the Assembly passed a bill, which she co-sponsored, to amend the insurance law from mandating their insured to purchase prescribed drugs from a mail order pharmacy. The bill did not pass in the Senate.

Other pharmacies in the area are being hit with the same problem. And it's not just DEHIC that mandated this change, Neumann said the Center for Discovery is now requiring their employees get mail order prescriptions. She said she's seen a big decrease in sales from that.

Jeff Pharmacy has been in business for many years, and Neumann has been the owner for seven years; they have five employees. She worries that she will have to cut back on costs, which would likely include downsizing employees. “This is how we pay our bills,” Neumann said.