Cambridge, MA – A new study, Physician Dispensing in Pennsylvania, 2nd Edition, from the Workers Compensation Research Institute (WCRI) found physician dispensing continued to grow rapidly in Pennsylvania.
According to the study, physician-dispensed prescriptions accounted for 29 percent of all prescriptions and 48 percent of prescription payments in 2012 evaluated as of 2013—an increase from 17 percent of prescriptions and 17 percent of prescription costs four years earlier.
“In many states across the country, including Pennsylvania, policymakers are debating whether doctors should be paid significantly more than pharmacies for dispensing the same drug,” said Dr. Richard Victor, WCRI’s executive director.
The report is an update of the previous study that examined the prevalence and costs of physician-dispensed prescriptions in Pennsylvania. With an additional year of data, the study continued to find higher and growing prices paid for physician-dispensed drugs. For example, the average price per pill paid to physicians for hydrocodone-acetaminophen (Vicodin®) increased by 71 percent in four years (there was a slight increase of 10 percent for the same drug dispensed by pharmacies). As a result, the price paid to physicians was more than three times as high as the price paid to pharmacies for this same drug ($1.38 versus $0.40 per pill). Large price differentials were also seen for many other drugs commonly dispensed by physicians in Pennsylvania.
Issues of physician dispensing have been actively debated in Pennsylvania. House Bill 1846, as amended by the Senate Labor and Industry Committee, limits reimbursements for physician-dispensed drugs to 110 percent of the average wholesale price (AWP) of the original manufacturer National Drug Code (NDC) or the AWP of the least expensive clinically-equivalent drug if the original NDC is not included in the bill from the dispensing physician. The same amended bill also limits physician-dispensed Schedule II and III narcotics to a 7-day supply after the initial treatment and a 20-day supply for all other drugs if dispensed in physicians’ offices.
The data used for the report came from payors in Pennsylvania that represented 45 percent of the claims in the state workers’ compensation system. There were 58,000 claims included that had more than seven days of lost time with injuries arising from October 1, 2007, to September 30, 2012, and 447,000 prescriptions filled through March 31, 2013.
Click here to purchase a copy of the study: WCRI: Physician Dispensing in Pennsylvania, 2nd Edition