On August 3, Zach Matheny’s blood thinning medication was filled at his pharmacy, and sent out for delivery via the U.S. Postal Service. It never arrived.
“After a week I started to get worried, so I went ahead and called the pharmacy," Matheny says. "And after some back-and-forth, they essentially gave me the answer along the lines of, ‘Well it might be lost because of everything going on.'"
Cutbacks at the U.S. Postal Service have raised concerns in regards to November’s election, but they've also created immediate worries for Ohioans who rely heavily on the service to obtain life-saving medications.
There have always been minor issues with medication delivery by mail, but that problem has been exacerbated by recent changes imposed by the Trump administration, like limits on overtime and a requirement that trucks leave on schedule, even if mail isn't loaded yet.
Matheny called the Postal Service, which said they couldn’t locate his medication. He called his insurance, but they wouldn’t approve another refill because the medication is too expensive.
So Matheny has been buying a single blood thinner pill from a community pharmacy every few days, when he can afford it. He’s spent more than $400 so far.
He’s hoping that will tide him over until next month, but he’s still worried about the consequences of skipping days of his medication.
“I could die,” Matheny says. “The issue with blood clots is, if you do not catch it in time, they will move up through your body, get up to your brain and explode... I’m really worried.”
Matheny is not alone. According to data from before the COVID-19 pandemic, collected by the Kaiser Family Foundation, Ohio residents rely on mail-order prescriptions more per capita than any other state in the country. Among those who depend on the service are the state’s most vulnerable residents: patients with chronic health issues, in rural areas, veterans, and the elderly.
Since the pandemic, even more Ohioans have opted to receive their medications by mail, to avoid possible exposure or to save money.
“We have heard some extreme anecdotes over the last couple weeks where patients are waiting one, two, three weeks for their medications,” says Antonio Ciaccia of the Ohio Pharmacists Association, who adds that he's never heard so many complaints about delivery delays.
Central Ohio doctors say the delays are not because of manufacturing issues. Instead, they’re happening between when a pharmacist fills the order and the medication arrives at the patient’s door.
And the USPS's recent decision to decommission some mail-sorting machines could make delays even worse, especially in populous areas like Columbus.
“There, in the Columbus area, we’re not really seeing the major delays that you’re hearing being reported across the country,” says Mark Camilli, Ohio's representative in the National Association of Letter Carriers. “In the northern parts of Ohio, there’s been more so, but in the Columbus area itself we’re not just seeing multiple days of delays now.”
Camilli says delays of one or two days are happening, sure, but not weeks like Matheny experienced.
Even a few days' delay, however, can harm a person’s health. And Ciaccia says many Ohioans have no choice but to get their medications through USPS.
“In general, we find that a lot of patients are pressured or forced into mail order,” Ciaccia says. “So a lot of mail order uptake can be attributed back to requirements by pharmacy benefits managers or insurers to get their medications through the mail.”
If medications arrive late, Ciaccia says they may have been improperly stored and no longer effective. If the medications never arrive, like with Matheny, the patient either goes without or pays out of pocket.
“This is not going to be life or death for everybody,” Ciaccia says, “but for a significant amount of patients that rely on these medications to stay well and stay alive, any type of delay in drug therapy could mean the difference between a patient being in the hospital, and a patient being in the ground.”