Sometimes, aspects of the law in one area affect aspects of the law in another.
One example of this so-called ‘rule of unintended consequences’ is the affect that physicians (as opposed to pharmacists) dispensing medications has on workers’ compensation costs.
In many states, including in New Jersey (for those doctors possessing a special license), doctors are allowed to give medications directly to patients, bypassing pharmacies in part or entirely. According to one recent op-ed on the subject (http://www.philly.com/philly/health/Do-consumers-benefit-when-doctors-dispense-medications-instead-of-pharmacists-.html), advocates for patient dispensing cite a number of benefits, including, “(1) improved patient access to medications, (2) patient convenience, (3) greater use of lower-cost generic medications and (4) therapeutic substitutions due to the physician’s enhanced awareness of medication costs, and (5) improved patient adherence with medication regimens.”
However, those benefits aren’t without a price. There are increasing doubts about whether physicians can properly navigate the potential conflicts of interest that arise from being both those that prescribe medication and those that profit from its sale.
“An oft-repeated concern,” the op-ed notes, “is that the more they prescribe the more they profit.”
And this concern was echoed in one recently released California study (see http://www.propertycasualty360.com/2013/03/05/cwci-physician-dispensing-increases-workers-comp-t). In a ten-year examination of physician dispensing, the California Worker’s Compensation Institute (CWCI) found a link to workers’ compensation costs.
According to the study, which analyzed benefits paid from 2002 to 2011, workers’ compensation claims that included physician-dispensed (repackaged) drugs “averaged $6,017, or 17 percent more than the $5,145 average for claims without these types of prescriptions. Additionally, these types of claims “also involved longer periods of disability…8.9 percent more than the average of 40.5 days.”
Though correlative studies are not always the most scientifically sound methods to deduce cause-and-affect, these numbers are far from insignificant. And, while further study may need to be done, these figures give pause to consider potential unintended consequences of all sorts of policy decisions.
