Physician Dispensing and Markups on the Rise

The frequency and costs of physician prescription in-office dispensing are increasing at a rapid pace.

A new study, Physician Dispensing in Workers’ Compensation, from the Workers Compensation Research Institute (WCRI) evaluated 5.7 million prescriptions paid under workers’ compensation for approximately 758,000 claims from 23 states over a period from 2007/2008 to 2010/2011.

WCRI found that medications dispensed in physician’s offices were higher priced than the same drug at a local pharmacy.

For example, in Florida, 62 percent of all prescription drug spending for workers comp cases was paid to physician-dispensed drugs.  Vicodin®, the most commonly used drug, cost more than double the pharmacy’s  $0.43, at $1.08 per pill at the physician’s office.  They were also much more likely to prescribe additional drugs like Prilosec or Zantac than physicians in other states.

This practice is cited for raising costs to employers.

Now, in-office dispensing can be a valuable service for patients, and a source of revenue for our urgent care practices.  Often in worker’s comp cases, we’re concerned the patient may not get the prescription filled right away.  Patients don’t want to wait around at the pharmacy once they’ve spent all the time in your office getting evaluated and treated.

But the convenience may not offset the pressure to keep costs at bay in all aspects of healthcare.

Do you dispense in your office?  Is it a significant source of revenue?  How do your patients respond?

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