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Pennsylvania’s drug problem

The profiteering plunderers of the workers’ comp system have moved into the Keystone State, proffering their repackaged drug get-rich-quick scheme for physicians treating workers’ comp claimants.

Patient safety?  Hah!

Conflict of interest? So what!

Higher taxes?  Screw ’em!

Alas, there’s no evidence of movement on the part of PA’s legislators to address the issue, despite the public discussion of problems inherent in physician dispensing.  An article in the Philadelphia Enquirer last year noted:

“A 2007 Institute of Medicine report showed that medication errors originate most often during the medication prescribing process. At least half of these prescribing errors are detected and corrected when pharmacists review the safety and appropriateness of the medication. [emphasis added] But having the same physician prescribe and dispense eliminates that safety net before the error reaches the patient…

Don’t let advocates for doctor dispensing fool you. The potential safety issues with physician dispensing cannot be easily dismissed.”

Despite the concerns, physician dispensing is increasing in PA.  WCRI reports that a fifth of all drugs were dispensed by docs in 2010/2011, accounting for 27% of drug costs – up from 15% in 2007/2008. The price for doc-dispensed generic Vicodin went up 23% over that period – while the cost for the same drug bought at a pharmacy dropped 10%.

In all likelihood, doc dispensing now accounts for over a third of all costs in Pennsylvania, increasing employers’ and taxpayers’ costs while endangering even more patients.  

To be sure, physician dispensing advocates will trot out their hoary arguments that dispensing reduces costs and speeds return to work, tired old lies that have been exposed by the CWCI’s research proving the opposite is true – medical and indemnity costs are higher for claims with physician dispensed drugs. Unfortunately, it does not appear the industry’s shills will have to stir themselves at all, as there doesn’t appear to be much interest on the part of the worker’s comp industry or their advocates to do anything about the problem.

Perhaps when the press uncovers a patient killed by a dispensing doc they’ll decide it’s worth their time.  That will happen.

What does this mean for you?

Until then, employers and taxpayers will just have to pay more for drugs claimants may well not need at prices inflated two to twelve times.


4 thoughts on “Pennsylvania’s drug problem”

  1. PA’s fee schedule for labs is one of the only ones in the entire country that does not have codes listed for drugs of abuse and as such testing for these drugs is not reimbursed by the state for Medicaid recipients. Ridiculous!

  2. Joe – thanks for bringing PA into the spotlight. I’ve been using your blog and other sources to try and educate PA legislators and the business community. Unfortunately one key legislator’s comment sums up another obstacle we are up against (paraphrasing): if the topic is not being headlined in the newspapers, unlikely any action wil be taken. We need employer vocal and financial support to motivate legislative action.

  3. Yet another reason why Doctors of Chiropractic should be utilized initially. Medical Doctors and their Medicine secondly, and surgery if needed Lastly! Chiropractic care has been proven to save the healthcare insurance industry millions of dollars. Of course there are cases that would not be served by Chiropractic, however, MANY cases respond to our care faster and at less cost than the medical route.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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