Living in the land of PillPack - (4/30/2019)

By Dr. Ron Gasbarro

Tony came into the pharmacy to buy a few greeting cards. “Hey, stranger,” the pharmacist shouted out to Tony. “Haven’t seen you in quite a while!” “Sorry, Doc,” Tony replied sheepishly. “But I have been getting my prescriptions through PillPack.” What is PillPack? It is a free online pharmacy service that sorts and pre-packs medications according to time of day – usually morning, afternoon, and evening. For example, let’s say you take a heart pill, a stomach pill, and an arthritis pill in the afternoon, those 3 pills are in their own packet, clearly marked, ready to be opened. There are no vials, no insurance hassles, and no forgetting whether you took your afternoon meds. The service is free and your medications are mailed to you each month. 

Sounds too good to be true? First off, know that you are at the mercy of the mail. If there is a snowstorm, a hurricane, or if it gets lost or delayed, you will not have your drugs in hand and on time. If there is a mistake in a medication for whatever reason, this will take time to resolve. Also, if your heart, stomach, and/or arthritis pills change color or shape – as generic drugs tend to do – you might not notice that. You may not even know that it is the wrong drug, accidentally packed with your other drugs. The pharmacist remembered when Tony was given a pain pill that was a different color than what he was used to getting from the neighborhood pharmacy. Before Tony left the store, the pharmacist made sure that Tony understood that it was the same drug at the same strength that he had been getting previously. No confusion. No waiting for days. No chance of taking a completely different drug in error. 

Also, take note that PillPack does not accept all types of insurance. Yes, PillPack does accept most major insurance plans, including most forms of Medicare Part D. However, the company is not “compatible” with Humana, Optum, coverage provided by the US Veterans Administration, or state Medicaid plans. “Compatible” means that if PillPack does not honor your prescription plan, your co-pays may increase significantly. Given their very public fight with Express Scripts a few years ago when they wanted to make PillPack unavailable to their 85 million customers, you always should ask your health insurance company before you subscribe to PillPack. 

The Better Business Bureau (BBB) gives PillPack its highest rating – an A+. The BBB rating is based on information it is able to obtain about a business, including complaints received from the public. BBB ratings are not a guarantee of a business's reliability or performance. Instead, the BBB recommends that consumers consider a business's BBB rating as well as all other available information about the business.

Despite a high rating, customers have complained to the BBB about their PillPack experience. Grievances typically involve not getting medications on time, poor communication between PillPack and prescribers, and misunderstandings regarding which insurance plans will cover the service.

How do you know whether PillPack will help you take medications more efficiently? Make sure you ask the right questions when talking to PillPack, such as getting a complete breakdown of monthly charges. Call your insurance company and ask whether they are in PillPack’s network. Remember that PillPack is really a pharmacy, not an insurance company. While PillPack can be a valuable service, there is nothing like a having a corner store pharmacist that you can ask real-time questions and get real-time results. The convenience of mail drug deliveries only matters if the mail order company gets it right.  

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Read more at

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