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Some pharmacy benefit managers and third-party administrators are hoping to reduce the effects of physician drug dispensing outside of the legislative arena.
Candy Raphan, director of medical management services at Broadspire Services Inc. in Sunrise, Florida, said the TPA recently “took a very common-sense approach” by communicating directly with seven of the highest dispensing providers in Georgia.
Ms. Raphan said Broadspire sent letters to the physicians informing them that injured workers have a way to get medications through pharmacy benefit managers, and that it's safer for injured workers to fill prescriptions at a pharmacy where there are multiple safety checks at the point of dispensing.
The company saw a 47% decrease in physician dispensing nine months after sending the letters.
“Communication is really important,” Ms. Raphan said. “I really do believe that physicians want to do the right thing ... and I do believe also that sometimes they just really are not as aware as they could or should be of what actually is happening.”
Express Scripts Inc. is using its Physician-Dispensed Medication Solution, started in February, to minimize costs by processing bills for physician-dispensed medications in accordance with state rules and guidelines, in addition to increasing safety by educating injured workers, said St. Louis-based Jennifer Kaburick, vice president of workers compensation product management and strategic initiatives at the pharmacy benefit manager.
“Historically people have the thought that, in workers comp, since there's no cost to the injured worker, that they really don't have any financial incentive to be concerned about the cost of medication,” Ms. Kaburick said.