9 Ancillary Services That Can Boost Practice Revenue

Leigh Page

Disclosures

August 07, 2014

In This Article

How In-House Dispensing Works

PTC will prepackage the drugs in several set amounts, such as 30, 60, or 90 pills. Another vendor, Physicians' Pharmaceutical Corporation (PPC) in Knoxville, Tennessee, does not even use prepackaged amounts. Chris Jaffurs, President of PPC, said the company brings in its own highly trained pharmacy tech to work full-time at your practice. Working in a dedicated room, the tech packages medications in whatever amounts the doctor orders, as a pharmacy would do.

Whereas most states allow physicians to dispense drugs in-house, it is prohibited in 2 states (Montana and New York) and significantly restricted in 3 more (Massachusetts, Texas, and New Jersey). In Texas, for example, in-house dispensing is limited to rural counties and government programs, whereas New Jersey limits it to oncology or HIV drugs, according to Moseley. Two states, Arkansas and Utah, recently lifted their bans.

Be forewarned that in-house dispensing has suffered some bad press, having to do with practices that overcharge workers' compensation patients. In July, the New York Times reported that some practices have been charging almost 10 times pharmacies' price for ranitidine.[4]

Jaffurs and Moseley say that these abuses have been limited to workers' comp programs, which have not been able to control payment levels. They say health insurers deny exorbitant billing. Both CEOs said that their client practices charge patients the same price that pharmacies charge. The American Medical Association Code of Ethics notes, "Physicians may dispense drugs within their office practices provided such dispensing primarily benefits the patients."[5]

Tinsley, the Houston consultant, was not enthusiastic about dispensing because it is highly regulated in such states as Texas. "To dispense meds in Texas, you're going to have to comply with state pharma regulations," he said. "You have to have a pharmacist involved and have to meet certain physical requirements."

Dispensing Scorecard

Start-up costs: Less than $10,000.

Potential income: Upward of $40,000 a year.

Pros: Convenient for patients and may improve their health, because they are more likely to take their medications.

Cons: This service may be banned or highly regulated in your state, and some patients may be distrustful of doctors selling drugs.

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