Greater Claim Costs. Longer Injury Durations. Dispensing Physician Heal Thyself.

26 Feb, 2013 Bob Wilson


#PDSummit -Well, I am flying back from the Physician Dispensing Summit in Boston, and what a worthwhile trip it was. We already knew that physicians dispensing repackaged drugs drove prescription costs up. We knew that the battle to stop this practice has been long and hard. And we suspected claims that they improved care and lessened injury durations were without merit.

Now we have the evidence. Patients treated by physicians who dispense their own medications have greater average benefit costs, greater indemnity expenses and take longer to return to work. 

Alex Swedlow of the California Workers' Compensation Institute (CWCI) released a brand new study at the summit that shows some startling numbers that tell the sordid tale. California took action several years ago to restrict pricing on repackaged drugs, but did not restrict physician dispensing. The result drove the cost of those drugs down dramatically, but surprisingly, it did not lower the rate of physician dispensing in the state significantly. Most interestingly, CWCI has found that, since those reforms, total average medical benefits for patients of these doctors has run 37% higher than patients of non-dispensing physicians. Indemnity costs have run 28% higher, and total PTD days are 9% greater for these injured workers. Overall, Swedlow showed that the post reform overall total benefit cost increase PER SCRIPT was a whopping $545 to the average claim. That was $545 per script, folks.  

The summit was the result of a cooperative effort between PMSI, Progressive Medical and Health Strategy Associates. It was intended to bring together both experts and competitors, along with really smart people, and me, to help define the issue and develop a cohesive strategy moving forward.  

It was a day well spent. 

And there was so much more. A great deal of time was spent discussing safety concerns for these patients, as these physicians may be working in an information vacuum in relation to their patients overall drug regimen. Their utilization of Prescription Drug Monitoring Programs was discussed, among other issues along those lines. Regulators from Illinois and Michigan shared ideas from their successful efforts to fix the price disparity that is such a concern to the industry.  

One of the biggest developments, in my view, was the presentation by Leigh Ann Pusey, CEO of the American Insurance Association. Her discussion of the issue - indeed her very presence at the summit - sent a clear message that the AIA would likely be an engaged and valuable partner in this effort. 

There are many details that I want to share, but it is late, I'm tired and I still have two free drink coupons left on my Southwest flight home. Lord knows you don't want me writing after those are gone. I will expand on some of these points in future articles, but wanted to provide a quick update as to what went down today with the hot topic of Physician Dispensing. Thanks to PMSI CEO Eileen Auen, Progressive Medical Co-CEO Emry Sisson, and Health Strategy Associates Joe Paduda for giving life and fresh air to a stellar idea. 

In the meantime, I can only say the facts are in. Dispensing physician, heal thyself. Or perhaps I should say work harder on healing thy patient. 

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