Medco Health Solutions Inc., the nation’s largest pharmacy-benefits manager (PBM), posted a 32 percent rise in fourth-quarter profits today — largely on the growth in the number [...]]]> You might find it interesting that — with the economy seemingly crumbling around us — one line of business is doing very well indeed: mail-order pharmacies.

Medco Health Solutions Inc., the nation’s largest pharmacy-benefits manager (PBM), posted a 32 percent rise in fourth-quarter profits today — largely on the growth in the number of prescriptions filled by mail order. Working with employer-based insurance providers, Medco fulfills more mail-order prescriptions than any other company in the United States.

If you have employer-based insurance, it’s likely that your insurance company is now working with a PBM like Medco — and is encouraging you to use them. For the consumer, it can be a good thing — because PBMs have the bargaining power with Big Pharma to bring down your prescription drug prices, and you’re generally not going to see the wide variation in pricing that you do in shopping at your local retail pharmacies.

But as someone who’s observed and participated in the mail-order pharmacy business for some time now, I’ve noticed an irony here.

After Canadian mail-order pharmacies emerged on the scene in the ’90s, representatives of Big Insurance and Big Pharma criticized the whole concept of the online pharmacy.

They said it was dangerous to order drugs without having face-to-face contact with your pharmacist.

They said that a personal relationship with your pharmacist was just as important as with your doctor, and that you should never order drugs by mail.

Now that they’ve co-opted the idea, though, they love it. Absolutely love it.

We’re actually glad people are learning some of the benefits of mail-order pharmacies through their employer-based insurance. Because, God forbid, if they lose their jobs and their COBRA runs out (or they can’t afford their COBRA), they’re going to need another solution.

And saving up to 80 percent off U.S. retail prices through licensed Canadian mail-order pharmacies is, hands down, the best solution out there for the uninsured.