A Multistate Perspective on Physician Dispensing, 2011–2014

By Dongchun Wang, Vennela Thumula, Te-Chun Liu

July 11, 2017 Related Topics: Physician Dispensing, Prescription Drugs and Opioids

As of June 2017, 22 states have made legislative or regulatory changes to rules governing reimbursement for physician-dispensed pharmaceuticals. This report documents the state of physician dispensing across 26 state workers’ compensation systems. It also evaluates the impact of the price-focused reforms in a multistate context, focusing on the frequency and costs of physician dispensing between the post-reform states and the non-reform or pre-reform states.

The data used for this report came from payors that represented 36–68 percent of all medical claims across 26 states. The states included in this study are Arkansas, California, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. The detailed prescription data cover service years from 2011 through 2014, for all medical claims with 24 months of experience.

The study also includes a research brief, which appears at the beginning of the document.

A Multistate Perspective on Physician Dispensing, 2011–2014. Dongchun Wang, Vennela Thumula, and Te-Chun Liu. July 2017. WC-17-30.

Copyright: WCRI

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Research Questions:

  • In which states was physician dispensing common and representative of a significant share of prescription costs?
  • How did the average price paid for common drugs compare between physician- and pharmacy-dispensed prescriptions? How did price differentials compare between post-reform states and states with either no reforms or where only pre-reform experience was observed?
  • Did the reforms help reduce the prices paid for physician-dispensed drugs?
  • Are the price-focused reforms effective and sustainable in the presence of higher-priced new drug products? 

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