Physicians groups, including the Florida Medical Association, the Maryland State Medical Society and Maryland Workers' Compensation Health Care Association, are arguing that doctors will stop dispensing drugs if price caps become law in Florida and Maryland.
Florida lawmakers are scheduled to debate a proposal to cap the price for repackaged drugs at the original manufacturer's average wholesale price plus a $4.18 dispensing fee for the fourth year this session.
Maryland lawmakers are considering a bill that would limit physicians to dispensing a 30-day supply of drugs to injured workers within 72 hours of an injury or discovery of an occupational disease.
Automated Healthcare Solutions (AHS), which sells dispensing software to doctors, argues injured workers face delays from carriers and pharmacies when doctors don't dispense the drugs.
Arizona, California, Colorado, Connecticut, Georgia, Illinois, Michigan, Mississippi, South Carolina and Tennessee all have adopted rules capping the price of repackaged drugs.
Idaho just passed a law that ties payments for repackaged drugs to the original manufacturer’s wholesale price without any separate reimbursement for the doctors who dispense the medications. The rule takes effect July 1.
But Hawaii can't get a deal done. None of the four repackaged drug bills introduced in Hawaii were passed ahead of a March 7, 2013, deadline for bills to move from their house of origin.
Some states, such as Texas, prohibit physician dispensing whatsoever.
Perhaps it is coincidental, or maybe it's part of the equation, but Texas' workers' compensation costs are among the lowest.
So here we have a plethora of states, likely with good data, to either enforce or refute the arguments advanced by AHS, the Florida Medical Association, the Maryland State Medical Society, the Maryland Workers' Compensation Health Care Association, and others who are against repackaged drug price caps or physician dispensing prohibitions.
It seems to me that if these folks had a good argument they would be presenting studies based on the data from these states that have implemented different practices to determine: a) whether doctors stop dispensing drugs if there are price caps and, b) what sort of delays, if any, are faced by injured workers who can't get their drugs from their doctor directly.
Maybe they have an argument, but if they do then it should be supported by data and facts, not hyperbole. Prove it and the skeptics will shut up.
But without solid evidence behind the arguments I, and many others, am having a very tough time believing the prognostications of dooms day for injured workers or physicians.
In the meantime, the NCOIL model requires:
I don't know - these model laws don't seem too terribly invasive or restrictive. It seems to me that there is still plenty of reasonable profit available when a physician dispenses drugs directly to the patient. The point is to remove the inherent conflict of interest - there's a reason why dispensation of drugs is, by law and by practice, done by a pharmacy.
So if the opponents to repackaged drug controls have good, solid, peer reviewed studies proving their anecdotal arguments, please share them with the industry.
Florida lawmakers are scheduled to debate a proposal to cap the price for repackaged drugs at the original manufacturer's average wholesale price plus a $4.18 dispensing fee for the fourth year this session.
Maryland lawmakers are considering a bill that would limit physicians to dispensing a 30-day supply of drugs to injured workers within 72 hours of an injury or discovery of an occupational disease.
Automated Healthcare Solutions (AHS), which sells dispensing software to doctors, argues injured workers face delays from carriers and pharmacies when doctors don't dispense the drugs.
Arizona, California, Colorado, Connecticut, Georgia, Illinois, Michigan, Mississippi, South Carolina and Tennessee all have adopted rules capping the price of repackaged drugs.
Idaho just passed a law that ties payments for repackaged drugs to the original manufacturer’s wholesale price without any separate reimbursement for the doctors who dispense the medications. The rule takes effect July 1.
But Hawaii can't get a deal done. None of the four repackaged drug bills introduced in Hawaii were passed ahead of a March 7, 2013, deadline for bills to move from their house of origin.
Some states, such as Texas, prohibit physician dispensing whatsoever.
Perhaps it is coincidental, or maybe it's part of the equation, but Texas' workers' compensation costs are among the lowest.
So here we have a plethora of states, likely with good data, to either enforce or refute the arguments advanced by AHS, the Florida Medical Association, the Maryland State Medical Society, the Maryland Workers' Compensation Health Care Association, and others who are against repackaged drug price caps or physician dispensing prohibitions.
It seems to me that if these folks had a good argument they would be presenting studies based on the data from these states that have implemented different practices to determine: a) whether doctors stop dispensing drugs if there are price caps and, b) what sort of delays, if any, are faced by injured workers who can't get their drugs from their doctor directly.
Maybe they have an argument, but if they do then it should be supported by data and facts, not hyperbole. Prove it and the skeptics will shut up.
But without solid evidence behind the arguments I, and many others, am having a very tough time believing the prognostications of dooms day for injured workers or physicians.
In the meantime, the NCOIL model requires:
- Prices be based on the average wholesale price set by the original manufacturer and assigned to the National Drug Code used by the original manufacturer or on the stock packaging used by the authorized drug distributor.
- All pharmaceutical bills submitted for repackaged drug products include the NDC number of the original manufacturer registered with the U.S. Food and Drug Administration or the manufacturer's authorized distributor.
- Reimbursements to be based on the current published manufacturer's average wholesale price – calculated on a per unit basis – as of the date of dispensing.
- A repackaged national drug code shall not be used and shall not be considered the manufacturer's NDC number. When providers don't include the manufacturer's NDC number, reimbursements should be limited to the average wholesale price assigned to the lowest priced therapeutically equivalent drug.
- Dispensing fees otherwise provided in state law shall be payable when applicable.
I don't know - these model laws don't seem too terribly invasive or restrictive. It seems to me that there is still plenty of reasonable profit available when a physician dispenses drugs directly to the patient. The point is to remove the inherent conflict of interest - there's a reason why dispensation of drugs is, by law and by practice, done by a pharmacy.
So if the opponents to repackaged drug controls have good, solid, peer reviewed studies proving their anecdotal arguments, please share them with the industry.
In the meantime, states that are having a tough time regulating this practice need some legislators with some cajones, or at least a modicum of morals, to control what, to me, is nothing more than specialty interest profiteering at the expense of society.
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