Three out of four Americans would have their prescription filled in their doctor's office instead of a pharmacy if given the choice, according to a new survey. Translation? Docs are missing an opportunity to make more money. Licensing issues aside, wouldn't that be lovely in an era of capitation, pressure to round up patients for clinical trials and more scrutiny of free meals and trips?
The survey, which canvassed 1,023 adults, examined consumer attitudes of an FDA-approved service known as in-office medication or point-of-care dispensing. The practice involves distributing pre-packaged meds directly to patients at the point-of-care, saving them a trip to the pharmacy and allowing them to immediately begin their treatment.
This isn't a brand new practice, by the way, as noted by Tom Doerr, chief medical officer for Purkinje, a consulting firm that commissioned the survey. Why did it do that? Purkinje is a software and consulting firm that helps docs run their practices, and so this survey is another way to get their name out there. Why else do consulting firms conduct surveys?
Key findings:
- 84 percent say this would be more convenient; - 62 percent believe it would help them better manage their health; - 83 percent of households with children and 82 percent of those between 25 and 44 years old are most likely to have their scrips filled in a doc's office if given the choice; - 77 percent of folks with an annual household income of less than $25,000 and 72 percent of respondents between 25 and 44 years old were likely to agree that in-office dispensing would help them better manage their own health.
Hat tip to PharmaGossip
4 Comments
That's just what doctor's offices want - to stock $250,000 of inventory. Sign contracts with all the PBM and insurance companies they see for pharmacy benefits as well. Get a new computer system to make labels, transmit claims. Deal with 3rd party rejections. Hire additional staff that is actually competent in something we know nothing about - retail pharmacy.
On top of that - listen to endless complaints on why it isn't $4 like Wal-Mart or FREE like Publix.
There might be $$$ in it - but I don't see a lot of docs trying to do this. The exception would be a large, corporately managed group. But the logistics still don't work. There is a reason that many pharmacies are now 24/7/365 - I don't think you would see that at your clinic. Plus, I know pharmacies are not getting less busy and are sometimes inconvenient, but they actually know the process. Can you imagine the wait at the office by the time you show up for your appt., wait for a script to get filled. Talk about planning for the day......
Yeah you could sign up with this consulting firm to do all the grunt work, but how much is left after that? I think pharmacies make $5-10 per Rx on average. Take their fees out, and I am making $2.50 a scrip. Plus, with everything transitioning to mail order, you are talking about filling acute antibiotics and that's about it.
Geat idea, I guess, but not practical. Plus a good chunk of my patients like to stop at the drugstore to restock their beer or cigarettes. I likely won't put in a beer cooler in my office.
This is a surprisingly common practice, with industry sources estimating that approximately 15,000 physician offices dispense medications at the point of care. Of course, that's just a fraction of all physician offices, but it's nothing to laugh at.
These doctors don't stock hundreds of thousands of dollars of medicine! According to what I've learned about the service (from Allscripts and other suppliers), you stock 20-40 of your most common generic medications. They come prepackaged and safety sealed. When it's time to write a script for one of the drugs you stock in your office, you ask the patient if they want to save a trip to the pharmacy by receiving their prescription in the office. Most say yes, some say no.
The physician doesn't usually bother to bill the insurance company. It's usually a cash and carry model. Most patients are willing to pay $10 - $15 out of pocket for the convenience of skipping the pharmacy. For many patients, $10 - $15 is the same as their generic prescription insurance co-pay.
You can make extra money by dispensing medicine at the point of care, but it's my understanding most physicians offer the service to improve satisfaction and treatment compliance. In most cases, you're talking about an extra $10,000 - $15,000 a year ... just enough to make it worth the effort.
I hope this is helpful.
EMR Guy
Thanks for the heads up. If they are using the 40 common and cheap generics, these are very likely the same on the Wal-Mart list. That would certainly work in many areas of the country. Where I live, a doc charging $12 for a scrip they could get at Wal-Mart for $4 would make the local paper "Local Doc rips off Pts - story at 10"
You'd be surprised how many people are willing to pay an extra $8 to avoid waiting in line at the Wal-Mart pharmacy for one hour with a sick, screaming child.
Granted, some moms will want to fill their script at Wal-Mart, where they can also buy a gallon of milk, get their oil changed and eat lunch. For others, they just want to have the medicine and get back home. Milk and oil changes can come later. :)
The Wal-Mart formulary is also quite limited. Although the supercenter says it offers ~300 drugs, they count the same drug many times depending on the dosage. For example, generic Prozac qty. 30 at strength A, generic Prozac qty. 30 at strength B, etc.
Finally, Wal-Mart's $4 formulary doesn't include many pain medications, and I don't think it offers any types of controlled substances. When you just had a root canal in the oral surgeon's office, paying $15 for your pain medicine is much appreciated. The alternative can be more expensive, and probably very embarassing as you drool in the grocery store waiting room. Yikes.
The bottom line: in-office medication dispensing thrives on the concepts of convenience and privacy. Save a trip to the pharmacy, and get your STD medication from your doctor, and not the 18 year old kid who fills your script at the grocery store.