A Healthesystems publication

Fall 2013

Regulation Alone Won't Control Physician Dispensing

Prescribers are already exploiting loopholes in legislation enacted to curtail the practice of physician dispensing.  Physician dispensing and repackaged drugs are among the many hidden factors that significantly drive up pharmacy costs in workers’ compensation when not identified and managed effectively.

As more states enact rules to prohibit or limit the practice of physician dispensing or put fee schedules in place to regulate pricing, it is easy for workers’ compensation payers in affected states to feel secure that regulators have successfully addressed the matter. Unfortunately, physician dispensing is a moving target that payers and PBMs need to stay ahead of as the market responds to changing rules. Healthesystems has been tracking physician dispensing since 2009 and continues those efforts. Recent data indicate that key players in some markets are exploiting legislative loopholes.

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SOURCES

1 -Healthesystems proprietary data, 2010-2012.
2 -Wang D. The Prevalence and Costs of Physician-Dispensed Drugs, Workers’ Compensation Research Institute. September 2013.
3 -Wang D. The Prevalence and Costs of Physician-Dispensed Drugs, Workers’ Compensation Research Institute. September 2013.
4 -Wang D. The Prevalence and Costs of Physician-Dispensed Drugs, Workers’ Compensation Research Institute. September 2013.
5 -Lipton B, Laws C, Li L. Workers’ compensation prescription drug study: 2011 Update. NCCI Research Brief, NCCI Holdings, Inc. August 2011.
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