Prices for Physician-Dispensed Drugs in Pennsylvania Continued to Grow Rapidly

Share Article

This new 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.

Chart from the study.

Chart from the study.

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.

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 on the following link to purchase a copy of this study: http://www.wcrinet.org/studies/public/books/phys_disp_PA2_book.html.

ABOUT WCRI:

The Workers Compensation Research Institute (WCRI) is an independent, not-for-profit research organization based in Cambridge, MA. Organized in late 1983, the Institute does not take positions on the issues it researches; rather, it provides information obtained through studies and data collection efforts, which conform to recognized scientific methods. Objectivity is further ensured through rigorous, unbiased peer review procedures. WCRI's diverse membership includes employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies in the U.S., Canada, Australia and New Zealand.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Andrew Kenneally
Workers Compensation Research Institute
+1 (617) 661-9274 Ext: 257
Email >
@WCRI
since: 06/2011
Follow >
WCRI
since: 06/2011
Like >
WCRI

Follow us on
Visit website

Media

Chart from the study.