Constance Davis never knows when she opens her post office box if help will be there.
Ms. Davis depends on the mail for medications to treat her lupus and a bad back, but several times, she said, those prescriptions have been waylaid for days. Aiken and Augusta postmasters say the volume of medicine now moved through the mail is "huge," but they take it seriously and have received few complaints.
Ms. Davis said she receives her prescriptions by mail through a Medicare Part D insurance plan because it saves her a lot of money.
But medication mailed in mid-March didn't reach her until two weeks later. And that left her in pain for several days.
"These medications are not a luxury for me," she said. "I need them to function."
The Department of Veterans Affairs moved to mail-order prescriptions for many of its patients, and many public and private insurance plans that use pharmacy benefit managers have followed suit.
About 20 percent of all prescriptions now are handled by mail, according to a study last year by the Lewin Group for the trade group Pharmaceutical Care Management Association.
The amount of prescriptions coming through the mail has increased "hundreds of times in the last few years," said Augusta Postmaster James Sizemore. And, unlike some post offices, Augusta does not have the equipment to sort them automatically, so they are parsed out by hand, he said.
"That kind of mail, for a facility the size of Augusta, probably will always be handled manually because we simply don't have the volume that would necessitate bringing a machine in to handle it," Mr. Sizemore said.
And while he was aware of one of Ms. Davis' problems, he said the volume really hasn't been a problem.
"It hasn't really been an issue here, other than the fact that sometimes these folks think these prescriptions should be here sooner than they are," Mr. Sizemore said. "And unfortunately they're not."
While there is a "huge" amount going through Aiken, the post office tries to get it out the same day it comes in, Postmaster Kathy Jenks said. That's the standard it uses for first-class mail, even though most of the drugs are shipped at bulk mail rates, she said.
"We know people are waiting for their medicine, so we do give it a priority even if the mailer doesn't," Ms. Jenks said.
But the medications Ms. Davis needs come by priority mail, and that has not seemed to speed up the delivery, she said. The delay can create problems with some medications, including a generic form of the anti-clotting medication Plavix, that are supposed to be taken every day.
"If I don't get that, that's scary for me," Ms. Davis said.
UnitedHealth Group, which administers her Part D prescription plan, normally allows a week for drug delivery, and a two-week delay would be "very rare," spokesman Dominick Washington said. "That's something we'll certainly look into."
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
The Centers for Medicare and Medicaid Services estimated that 17 percent of prescriptions were filled by mail in 2004. That grew to about 20 percent last year and is expected to rise, according to a report prepared for the Pharmaceutical Care Management Association, which represents pharmacy benefit managers and promotes mail-service use as a way to cut costs.