Physicians in Connecticut dispensed 14 percent fewer prescriptions between 2011 and 2014 and the percentage of total prescription payments for physician-dispensed drugs fell 34 percent, according to a new study examining the prevalence and costs of physician dispensing in 2014 across 26 state workers’ compensation systems.
Connecticut in July 2012 enacted a law aimed at reducing the amount of pain medication Connecticut doctors were prescribing to injured workers by limiting the prices the prescriptions could fetch for physician-dispensed repackaged drugs to the manufacturer’s average wholesale price.
In the last decade, many workers’ compensation jurisdictions in the U.S. have made legislative or regulatory changes to rules governing reimbursement for physician-dispensed drugs to reduce higher prices paid to physicians than to pharmacies for drugs they dispense, according to the report from Cambridge, Mass.-based Workers Compensation Research Institute.
The study, A Multistate Perspective on Physician Dispensing, 2011–2014, found physicians dispensed fewer prescriptions after price-focused physician dispensing reforms. However, as of 2014, physician dispensing was still common and represented a large share of prescription costs in several states, including California, Florida, Illinois, Maryland, and Pennsylvania, WCRI said.
According to the study, the reforms reduced prices for existing drug products, which was evident in all post-reform states, including Connecticut. However, physician prices increased for several drugs commonly used to treat injured workers in several post-reform states, including California, Florida, and Illinois. The increase in physician prices in these states was a result of frequent physician dispensing of higher-priced new drug products, WCRI said.
When dispensing these new drug products, some physician-dispensers were able to bypass the reimbursement rules, which target physician-dispensed repackaged drugs, and were paid much higher prices than they were paid for existing strengths of the same drug. The results raise questions about the effectiveness and sustainability of the price-focused reforms in these states, WCRI said.
