Study says doctors increasingly fill prescriptions

Posted: July 20, 2012

Doctors are increasingly filling — and not just writing — prescriptions for workman's compensation patients in Pennsylvania and New Jersey, sometimes getting paid much more per pill than a pharmacy, according to a study to be released Thursday by a research group funded by insurers and state governments.

The Workers Compensation Research Institute, based in Cambridge, Mass., studied nearly 5.7 million prescriptions paid under workers' compensation for about 758,000 claims from 2007 to 2011 in 23 states, including Pennsylvania and New Jersey.

Not every doctor fills the prescriptions she or he writes. Some federal laws limit the ability of doctors to fill and directly profit from the prescriptions for drugs or tests. New York, Massachusetts and Texas prohibit the practice.

In Pennsylvania, 20 percent of the prescriptions for patients filing workman's compensation claims were filled by a doctor, up from the 17 percent over a three-year period used in the study. The percentage of payments to doctors for prescriptions rose from 15 percent to 27 percent during the same period.

In New Jersey, the prescriptions written by doctors rose from 11 percent to 18 percent, while the payments rose from 10 percent to 12 percent.

The study found that prices paid to doctors for certain drugs — some painkillers, some not — were higher than those paid to pharmacies, both retail and mail order.

"We rarely see a medical cost driver that has grown this rapidly," Dr. Richard Victor, WCRI's executive director said in a statement.

The New York Times recently reported that some distributors help some doctors set up pharmacies within offices, buy drugs in bulk and then repackage them. Repackaging has allowed those distributors and doctors to claim a higher reimbursement price than pharmacies get, though several states, notably California, have closed that loophole.

Greater focus on controlling health-care costs means that various sectors, public and private, are contesting how others make money or pay bills.

The WCRI insists that its research is independent, though the organization gets about 55 percent of its funding from insurance companies and about 20 percent from state governments, including Pennsylvania and New Jersey.

WCRI has been criticized by workers' compensation attorneys. The American Medical Association, which represents doctors, has a general policy that says, "Our AMA supports the physician's right to dispense drugs and devices when it is in the best interest of the patient and consistent with AMA's ethical guidelines."

Contact David Sell at 215-854-4506 or dsell@phillynews.com or Twitter @PhillyPharma. Read his PhillyPharma blog on philly.com.

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