Delivery speed and reliability are both essential to medication access. USPS has emphasized that the RTO initiative is intended to improve reliability, even as other elements of the DFA lengthens average delivery times. Whether that tradeoff achieves its intended balance remains to be seen. From a health perspective, however, even small delays can matter.
Research consistently shows that timely access to medication supports adherence and prevents costly complications. Mail-order programs are associated with 30-40% higher adherence rates compared with retail pharmacy use, particularly for chronic conditions that require uninterrupted treatment. Delays in delivery can interrupt medication routines, leading to higher rates of emergency department visits and hospitalizations.
Because mail-order prescriptions depend on the Postal Service’s nationwide delivery network, postal performance becomes a determinant of public health. Slower delivery and degraded reliability can undermine the routine behavior that adherence depends on, eroding the very reliability gains the RTO seeks to achieve. If patients begin to view mail delivery as unreliable, they may adjust their behavior in ways that reduce the effectiveness of mail-order channels as tools for sustaining consistent care.


