Is
this legal?
In 44 out of 50 states, it is
absolutely legal for physicians to do
point-of-care dispensing. The other states
restrict what physicians can do but even those
states still can dispense. The states that
are restricted are:
- New York
- Massachusetts
- Montana
- Texas
- Wyoming
- Utah (only state where it is
illegal)
Every Physician has the right to
dispense medicine to their patients. State
and Federal law requires physicians to dispense
only properly labeled and packaged drugs.
We will assist you on what licensing, if any is
required by your state regulatory
board. Typically it is a matter of
completing a short form and paying a small
fee.
How much time will it take
to dispense?
Adding point-of-care dispensing
actually can save time. Hours each
week are wasted by calling pharmacies as well as
taking pharmacy calls. It takes less than
one (1) minute to dispense medication to a
patient whether your staff uses the manual
or computerized tracking system.
It takes less than half an hour to learn the
manual system and anyone can
master the dispensing
software within a couple of hours.
Will dispensing cause my
malpractice insurance premium to
rise?
It shouldn't. A
physician's medical license mandates that they
are allowed to dispense medication and
frequently pass out drug samples already.
It shouldn't make a difference whether
or not you get paid to do so as far as
malpractice insurance is concerned. If
this is an issue for you, contact your insurance
agent.
I have never heard of this
before. Why aren't more physicians doing
this?
20 years ago, how many people had heard
of cell phones? Not too many.
Ironically, almost every physician years ago
dispensed medication to their patients.
Whether you decide or decide not to
dispense at this time, we think all physicians
will be dispensing one day. It is a sign
of the times. Change occurs in every
industry and the reduction of insurance
reimbursements and increasing costs are
forcing physicians to find alternative
sources of revenue to enhance their
practice. Dispensing medication is a
simple and easy income solution.
Will dispensing upset local
pharmacists?
It shouldn't. Many of the drugs that
will be prescribed by you will still be filled
by a pharmacist. A successful formulary
typically consists of 20 to 25 drugs and
they are mostly generic. When the
need arises for something other than what is in
stock, you will send the patient to the
pharmacy. You will dispense for
primary or acute care conditions and
use mostly generic drugs.
How do I determine what
price to charge my patient?
Simple. Do what any price shopper would
do. Shop. Call the local pharmacies
and find out what the cost of the medicine
is. Very often, you can go onto their
website and find out. Or better yet, ask
your dispensing consultant for advice.
For patients that have prescription cards, we
advise you to charge whatever the co-payment is
for a generic drug. Often, you can charge
an extra dollar or two simply because of the
ease and convenience of obtaining the
prescription at the point of care. What
patient wouldn't want that?
Can I really earn $50,000 or
more each year by dispensing?
Yes but that all depends on the
size and type of practice as well
as the number of patients seen each
day. Based upon averages, the average
physician will see 100 patients and write 100
prescriptions or more each week. Asking
yourself simple questions such as how many
patients you see per day or per week will
quickly give you an idea how much money you
could be earning by dispensing. Wholesale
cost per drug and what you charge the
patient is the final determining factor on
calculating potential earnings. Most of
the generic drugs will cost you
$6.00.
What are the start-up costs
to begin dispensing?
Other than the cost of the drugs,
nothing. In fact, in most cases, you will
pay your invoices either by credit card or
on terms so there really shouldn't be any
out of pocket cost at all. You
will start off on the manual dispensing
system and we'll custom print all of the
labels. Shipping is also free on minimum
orders.
Once you begin to re-order, we will suggest
going on the computerized dispensing system,
also at no additional cost to you. Some of
the competition charges for the software
and a monthly maintenance fee.
Is dispensing the same as
being a pharmacy?
No. Physicians may only distribute
pre-packaged medicine. We
recommend to physicians to
typically stock only 15 to 30 of the
most commonly prescribed generic
medication. In reviewing the prescribing
patterns the norm is usually 80% of all
prescriptions come from about 20% of the total
number of drugs that the physician
prescribes. Remember, the formulary is the
key to a successful dispensing system.
Is dispensing time
consuming?
No. Whether your
office uses the manual or computerized
dispensing tracking system, the entire
process takes less than one minute.
The medication is already pre-packaged, labeled
and ready to dispense. It's simple, easy
and very profitable.
Can someone else assist with
dispensing?
Yes. State by state rules may vary but
the office staff generally can help in preparing
and dispensing prescriptions. Very large
practices and clinics may hire a pharm-tech to
streamline the process.
The involvement of the staff is completely up
to you. Many offices delegate dispensing
to the nursing staff. They love the added
responsibility.
Which type of practices are
a good fit for dispensing?
Offices that prescribe
acute-care medications which treat
conditions that are cured by a single
course of therapy. Patients are usually
sick or uncomfortable and appreciate the
convenience of not having to make a trip to the
pharmacy. There's also the confidentiality
aspect of in-office dispensing.
Medications include antibiotics, pain,
discomfort and anti-inflammatory
drugs.
Some of the types of practices
include:
- Family Practice
- Occupational Medicine /
Workman's Comp
- Pediatrics
- Urgent Care
- Minor Emergency
- Walk-In Medical Centers
- Dermatology
- Dentists Such As Oral And
Maxillofacial Surgery
- Plastic
Surgery
If a patient has a
prescription card, doesn't it make financial
sense to be reimbursed by the insurance
company?
No. Most if not all of the drugs in a
dispensing program are generic drugs and you
will be better off taking the cash from the
patient. We suggest taking whatever the
generic co-pay is on the card which today is
around $15.00. If you were to turn in the
drug for reimbursement, you would be paid
significantly less. Prescription drug card
programs limit the profit to around a $2 - $3
dispensing fee just like a retail pharmacy.
Prescription drug card programs often
maintain a database of the physician's
prescribing habits which can be sold to insurers
and drug manufacturers. There is also
extra effort to adjudicate a claim in order to
get paid. It could take weeks or even
months to see a dime.
Can I choose any drug I wish
to sell including a name brand drug?
Sure but statistically, 93% of
all drugs are included in a formulary of less
than 250 drugs. With thousands of drugs to
choose from in different strengths and
quantities, the key to a successful formulary is
picking out which drugs move fast and make the
most profit. The reality is over time you
will fine-tune the formulary to what makes the
most sense for your practice. You may
purchase some name brand drugs that cannot be
obtained generic but in most cases, the
dispensing program will consist mostly
of generic medications.
The computerized dispensing
system provides detailed reports to help you
choose the drugs that are the best choice for
the practice. We'll provide you with
time-tested formularies that are financially
successful for other physicians making it easy
to choose what is right for your
practice.
Why are antibiotics
re-packaged in a separate
building?
Penicillin and
cephlasporin contamination of non antibiotic
drugs cause up to 50% of all drug reactions in
the US according to the FDA. One
unit of penicillin is invisible to the eye and
can cause anaphylactic shock to a sensitive
patient. It is virtually impossible not to
get a drug that is not contaminated with
penicillin/cephlasporin pore particles.
Not only are antibiotics repackaged in
another building but the rooms have negative air
flow too.
How will dispensing help my
patients?
Patient convenience is one
big reason. Patients appreciate receiving
medications in the physician's office and avoid
traveling to the pharmacy and waiting for their
prescription to be filled. Some
pharmaceutical chains require up to a 45 minute
wait to fill a script, so that the patient will
make impulse buys. Increased compliance is
another reason. 30% of all prescriptions
in the US never get filled, for whatever
reason. Why? Maybe your patients
hate to go to the pharmacy! Every patient
loves in-office dispensing. Patients will
often save money by obtaining their prescription
at the doctor's office verses the
pharmacy. Then there is also the
confidentiality of receiving their medication at
the medical office.
Will dispensing help
Medicare and Medicaid patients?
New enhancements with Medicare may
diminish the value of in-office dispensing to
those patients depending upon the prescription
plan they choose. Since most of the drugs
you would be dispensing are low-cost generic
drugs, selling generic medications for just a
few dollars above cost could still create
benefit for the patient and the practice.
Most elderly patients have a hard time getting
around. Some use public transportation and
may have to take a bus or walk to the nearest
pharmacy to fill a prescription. In-office
dispensing would eliminate that extra
trip. Furthermore, up to 30% of
prescriptions nationwide go unfilled.
Filling the prescription in the office will
positively affect your control over outcome
management.
How will dispensing help you
comply with the formulary compliance from top
insurance companies?
Formulary compliance is a very important
issue. Most doctors dispense "free
samples" of brand name drugs given to them by
their local pharmaceutical rep and then write a
prescription for that expensive drug. This
sample mentality has caused the total cost of
healthcare to increase considerably.
By implementing a successful in-office
dispensary, the medical office will
significantly reduce the at-risk formulary
compliance amount considerably. If the
physician had to dispense an expensive name
brand drug, he would want to purchase that drug
from us and sell it to the patient verses
writing the prescription. We have been
told that there is at least a $20 differential
in cost between a formulary and a non-formulary
drug, per script. E.g., if the physician
were to dispense a formulary drug purchased from
us for $30.00 and sold to the patient for
$40.00, he not only would make a $10.00 profit
on the differential between wholesale and
retail but would also save $40.00 because
that script would never be charged to their
risk-pool! If the physician was at a 100%
risk for formulary compliance, he would realize
a $50.00 profit per script.
What if I want to carry and
sell maintenance drugs?
Generally,
in-office dispensing works best for an initial
prescription. There are some physicians
who are quite successful with maintenance drugs
too. We have an open formulary so you can
order any drug other than type 1 and type 2
drugs.
Where will I store the
drugs?
About half of the physicians put the
medications in the same place as they now keep
their samples. To be compliant with FDA
and DEA regulations, you'll need a locked
cabinet or drawer. If you plan on
carrying controlled medication (narcotics), they
must be stored behind a double lock.
A simple solution is purchasing one of our
cabinets. There are many different kinds
to choose from. One of our locked cabinets
behind a locked door will satisfy the double
lock requirement for controlled medications.
How do I determine the
initial inventory?
The initial
drug-dispensing inventory is determined in
cooperation with you and a MedX sales Dispensing
Consultant. A drug formulary information
list is available with the top prescribed drugs
as well as specific formularies used by
specialized practices to help determine the best
fit. Once a decision is made for
the initial choice of drugs, our proposal
department will generate a quote for review and
execution. As time goes by, your ordering
pattern will change based upon profitability and
prescribing practices.
