Insight, analysis & opinion from Joe Paduda

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Sep
16

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WCRI’s just published a comprehensive guide to physician dispensing in workers’ comp, complete with cost trends, state regulations and legislation, individual drug price differentials, and a wealth of other great information.

Here is the key take-away.

  • in four states – IL MD FL CA – physician dispensing accounts for more than 55 percent of all drug spend.
  • In four more – CT PA TN GA – it accounts for more than 30%.
  • and it continues to grow across the board.

What’s notable is that after regulations to limit upcharging for repackaged drugs were put in place in California, the percentage of scripts dispensed by docs didn’t change appreciably.  

With other states, e.g. GA IL MI CT all taking similar action, we will know more about the impact of price controls on dispensing.  My sense is the controls will not significantly reduce physician dispensing.

That is too bad, as CWCI research proves physician dispensing increases medical costs over and above the higher cost of the drugs – while extending disability duration and total claims cost.

All to enrich a few docs and their dispensing company allies.

What does this mean for you?

Higher costs.  Worse outcomes.

 


Joe Paduda is the principal of Health Strategy Associates

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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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© Joe Paduda 2018. We encourage links to any material on this page. Fair use excerpts of material written by Joe Paduda may be used with attribution to Joe Paduda, Managed Care Matters.

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