Many Florida physicians are looking to dispense medications as one way to combat the reimbursement squeeze and proposed national healthcare reform while also creating a new revenue stream.

 

Physician dispensing is fully legal in Florida and endorsed nationwide by the American Medical Association. It is no longer complicated and costly to set up an in-office dispensary; companies now offer complete turnkey, point-of- care dispensing programs that allow physicians to dispense medications directly to patients. Some even offer web-based software that enables the physician's office to electronically connect to most pharmacy benefit managers for immediate claims adjudication and confirmation of reimbursement. These programs also fully automate the dispensing process and inventory control. Medications are prepackaged and sealed in counts commonly dispensed. Labels are printed when the drugs are dispensed and the dosage can be easily modified. The system also tracks usage and automatically reorders medications as needed.

 

"More and more physicians view drug dispensing as an effective way to supplement practice income," said Justin J. Fogg, an account executive with VantageRX in Orlando, who estimated that one in 10 doctors dispense medications in their offices. That percentage is rapidly increasing. "Depending on payer mix and prescribing habits, they can make an extra $40,000 to $200,000 per year, dispensing medications directly to their patients."

 

The practice of physicians dispensing medications isn't new. Historically, physicians dispensed the medications that pharmacists manufactured and/or mixed. In the early 20^th century, pharmaceutical companies began manufacturing and distributing medications, pharmacists began dispensing medications, and physicians were reduced to simply prescribing them. However, most primary care physicians already dispense medications via samples, infusions, and injections.

 

"While the most obvious benefit of in-office dispensing is the added revenue stream, it's often overlooked how much time can be saved each day by not having to deal with pharmacy issues," said Fogg. "It's been estimated that each pharmacy call back costs the physician on average $5 to $7 per call. A typical practice can spend $30,000 a year handling these pharmacy-related issues. Additionally, these issues can consume 6 percent to 12 percent of a physician's time. Therefore, in-office dispensing can also help reduce costs and improve management of overhead."

 

 

 

Studies show that by having physicians dispense medications, writing and dispensing errors are virtually eliminated, the number of patients getting their prescriptions filled and taking all the medications as directed is increased by nearly 60 percent, and the typical retail pharmacy wait time of up to an hour excluding travel time is bypassed. An added bonus: an increased compliance rate, which means better healthcare and overall lower healthcare costs.  

 

"More doctors would be dispensing were it not for fear of computers," said Richard D. Loew, MD, an internist and emergency medicine specialist from Stuart, who was initially reluctant to dispense medications. He quickly learned that the technological side could be mastered in half an hour.

 

"Patients like the convenience," said Lowe, who makes $4 to $6 per prescription. With 40 or more patients per day receiving at least two prescriptions per visit, revenues build quickly.