Florida’s Physician Dispensing Found to Drive Workers Comp Costs Higher

img1The Workers Compensation Research Institute (WCRI) reports this week in Prescription Benchmarks for Florida – 2nd Edition that physician dispensing is driving up prescription costs in Florida.

 

 

The study looked at the costs, prices, and distribution of drugs in the state and took a closer look at doctors dispensing medicine there. Findings showed the average payment per claim for prescription drugs in Florida’s workers compensation system was $536. This is 45 percent higher than the median of the states in the study making it number two out of 17 states. The last two years of the study showed an increase of 14 percent in average cost per claim though they were stable in other states in the study.

 

 

Legislation regarding physician dispensing was vetoed in 2010. Advocates of physician dispensing say it saves money because doctors are more likely to prescribe generics. Advocates also say that patient compliance, and, therefore, positive outcomes are more likely when doctors are doing the drug dispensing.

 

 

But the study showed this was not the case – generics were prescribed equally from both doctors and pharmacies. Further, even when using generics, the cost per pill was higher at the doctor’s office.

 

 

Higher and growing costs of prescription drugs in Florida were largely due to more frequent and higher-priced physician dispensing, the study indicates. “Physician-dispensing in Florida’s workers’ compensation system has been taking an increasingly larger share of prescription payments. The percentage of prescription payments for physician-dispensed prescriptions in Florida increased from 17 to 46 percent over a four year period,” according to the WCRI report.

 

WCRI’s 17-state study also provides some evidence that helps address concerns about legislation (H.B. 5603), passed in 2010, but later vetoed, that would limit reimbursement rates for physician-dispensed prescriptions to the same level as pharmacies for the same medications.

 

 

Other findings include:

  1. Physician-dispensers received 46 percent of prescription payments in the state.
  2. Average price paid to Florida pharmacies increased by 3 percent over the course of the study.
  3. California passed legislation regulating doctor dispensing and saw a large drop in cost per pill of physician-prescribed muscle relaxants. And physicians prescribed more non-repackaged drugs.

 

 

The 17 states included in this study are California, Florida, Illinois, Indiana, Iowa, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, North Carolina, Pennsylvania, Tennessee, Texas, and Wisconsin.(WCxKit)

 

 

WCRI is based in Cambridge, MA and is a nonpartisan, not-for-profit membership organization supported in its public policy research by employers, insurers, insurance regulators and state regulatory agencies, as well as several state labor organizations.


Author Rebecca Shafer
, JD, President of Amaxx Risks Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information.
Contact: RShafer@ReduceYourWorkersComp.com.

 

Our WC Book:  http://www.wcmanual.com

WORK COMP CALCULATOR: http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:  http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP: http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2011 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact Info@ReduceYourWorkersComp.com.

 

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