By Eugene Keefe
Keefe, Campbell Associates
One of our national
clients advised of a recent trenddrug compounding and repackaging to
make the simple pharmaceutical process much more expensive. In follow-up to our
first article, we note in recent years, compound drugs and drug repackaging have
gone hand-in-glove as ways in which workers compensation claims handlers
often have no idea what they are paying in handling Illinois workers
compensation claims. As we have advised on numerous occasions, it is amazing
Illinois has a medical fee schedule without a prescription fee schedule. This
change wont happen until Illinois business demands
it.
Compounded drugs are hand-made rather than mass-produced, and
supposedly tailored to the needs of individual patients. These practices are
mainly regulated by the states instead of the federal Food and Drug
Administration. The disparities resulting from 50 sets of rules and levels of
technical and inspection prowess shouldnt be allowed to continue.
Repackaged drugs are prescription or over-the-counter drugs taken from initial
drug producers and repackaged and repriced, usually by physician/clinic
dispensers. The cost is from two times higher to twelve times higher. In one
study, repackaged drugs accounted for less than a third of all prescriptions but
over half of all dollars paid. The concept is especially troubling when one
considers the overwhelming majority of the top 20 drugs are
generic.
As has been the case for the last several years, the
average prescription cost of compound drugs is well over the
national average. A growing percentage of the providers dispensing compound
drugs submit via paper, and many payers have had limited capabilities with
adjudicating these bills at the appropriate or allowable rates. While the number
of the compound drug paper bills is currently a small percentage of most
national payers overall prescription volume, the dollars associated with
these transactions and the potential savings can be high.
Continue reading
here