Frequently Asked Questions

Regarding the Point-of-Care Dispensing of Prescription Drugs
1. Can a physician legally dispense prescription drugs from his/her office?

Yes, every medical doctor has the right to dispense medication to his or her own patients. Only four states restrict the practice to any great degree (New York, Montana, Texas and Massachusetts). Even in these states, dispensing is allowed but restricted.
2. Isn't dispensing from the office time consuming and difficult for my staff?

Absolutely not. Dispensing Solutions, Inc. is the only drug repackager that has been refining in-office dispensing or over fifteen years. The DSI products and systems have been specifically designed to make the drug dispensing process simple for your staff, fast for the patient, and profitable for your practice. With the DSI system, the entire drug dispensing and documentation process can be completed in less than a minute.
3. Won't my patients be upset that I am selling drugs from my office?

Almost without exception, patients appreciate the convenience, higher quality and generally lower cost of receiving their medication directly from the doctor. Saving that extra trip to the pharmacy is one of the primary patient benefits of in-office dispensing. Even patients who otherwise pay less at a pharmacy will often rather receive their medication from their physician than to wait the average one-hour at a pharmacy.

4. Why do I need to purchase professionally repackaged drugs, why not just buy drugs in bulk and pour what the patient needs into a container and provide it to them?

State and Federal law requires every dispensing physician to dispense only properly packaged and labeled drug products to patients. Products must comply in most cases to Federally mandated current Good Manufacturing Practices (cGMP’s) as delineated in Title 21 of Code of Federal Regulations. Failure to comply with all of these stringent laws could render the drug dispensed as "adulterated" and or "misbranded". It is a federal crime to dispense an adulterated or misbranded drug to any patient.

5. How much will the program cost the practice?

With eDispense™, there are NO up front cost to the physician. The hand held program includes, DSI's proprietary hand held, completely wireless prescription writing device for the physician, DSI's dispensing software for the office computer, one drug storage cabinet and the medication necessary to manage the program. The cost of this program is covered with a revenue share program with the physician. The standard DSI program can be set up for less than $800. The standard program includes the hardware necessary for managing the program (computer, monitor, key board, laser printer, special high quality/small footprint label printer) and free access and use of DSI's proprietary drug dispensing and tracking software. The only other cost in the standard program is for DSI's unique, DEA approved, lockable space efficient drug dispensing cabinets and for the drug inventory itself.
6. What level of profitability can the practice expect from the program?

The DSI program has worked successfully in many thousands of physician offices for over ten years. Most physicians can expect to generate from $25,000 to well over $100,000 in additional revenue without increasing their patient base by a single patient.
7. How can I protect the relationships I have with my pharmacist colleagues?

The average dispensing physician dispenses only about 15 to 25% of the total prescriptions written in the office. The pharmacy industry currently reports that about 30% of prescriptions written by physicians are never filled by the patient. The DSI system's "fax-to-pharmacy" feature provides the most efficient method currently available to capture these prescriptions for the pharmacist. Even though the physician is generating a significant new revenue source, the local pharmacists typically generate more revenue because more of the otherwise unfilled prescriptions are captured.
8. What are the components of the DSI point of care drug-dispensing program?

The system consists of DSI's repackaged drug product, a specially designed drug storage cabinet, special product labeling and the DSI drug dispensing software. All drug products are packaged in HDPE white plastic, square bottles to match the original manufacturer packaging system. Every container has a metal foil induction seal to assure the highest level of product integrity. Every DSI product label is color coded for fast identification and includes four product segment labels for fast and simple documentation of the dispensing process. The square bottles fit into DSI's DEA approved, lockable, steel, space efficient drug storage cabinet, which automatically assures first in, first out inventory control. Every container is labeled on the bottom of each bottle so once loaded in the cabinet the container will never need to be touched except to dispense. The DSI drug cabinet is less that three inches thick and will fit behind a door. The cabinet will hold approximately 180 individual prescriptions.

9. What are the components of the data collection program?

With DSI's new hand held program, the physician, simply utilizes the hand held device to generate a prescription. The device utilizes fast drop down menus that allow the physician to generate a clear and accurate prescription in seconds. The final selection allows the physician to print a product label for in office dispensing, generate a printed prescription for the patient to take to the pharmacy of their choice , or to electronically fax a prescription to a pre selected pharmacy. Each choice is transmitted through the wireless system to the front office computer where the transaction is completed without any additional steps from the physician. To complete the in office drug dispensing process, the drug to be dispensed is pulled form the cabinet, the product label is verified and affixed to the container. The system provides the appropriate product and chart labels and the properly labeled drug is dispensed to the patient.

10. Must I participate in all phases of the program to utilize the DSI system?

No, the system has been developed to accommodate virtually every size and type of office. The dispensing portion of the program is designed to improve the quality of the medication being delivered to patients, significantly improve patient drug therapy compliance and to generate a substantial new revenue source for the practice. The data collection and tracking software is designed to easily, quickly and legally manage the practice's entire prescription drug program, while creating a data base that is valuable both immediately and as a potential additional source of revenue for the practice.

11. How much additional work will the data collection portion of the program require?

The data collection process happens as a result of the dispensing/prescribing process. No additional work is required.
12. What level of income can I expect from the data collection and drug rebate programs?

At this point the data collection and rebate programs are under development. The expectation is these programs should generate as much as or more revenue than the drug-dispensing portion of the program.
13. How would I participate in the data research portion of the program?

The data collected as part of the regular program will be available through the system reports, for any physician who wishes to participate in the research programs. Little additional work should be required.
14. Is the DSI software easy to use?

The software has been refined for many years specifically for use in a busy physician's office. It is designed to be easy to use, fast, and to automatically perform many functions that are currently done manually in the office.

15. How much time does it take my staff to become proficient with the system?

Training on the system takes usually less than an hour. Real proficiency is usually achieved after only a few days of using the program.
16. How much time will it take to enter a new patient into the database?

A new patient can take between several seconds to a few minutes depending on the level of data the physician wishes to capture. The minimum information needed by the system can usually be completed in less than a minute per patient.
17. What is the minimal information that I will be required to enter into the system for each patient?

The minimum information needed by the system is the patient's last name and first initial.
18. What other information can be added on each patient?

Most demographic information, insurance plan information, addresses, phone numbers, etc. are all built into the structure of the system. Except for the patient name, any additional information entered is up to the individual offices and will be determined by the specific programs in which the office participates.
19. How much time does the DSI drug dispensing process take?

In most cases the entire drug dispensing process takes less than a minute to complete.
20. Will I be dispensing starter doses of medication or full courses of drug therapy to my patients?

Most physicians choose to dispense a full course of therapy to each patient. Starter doses can be dispensed in some situations.

21. How do I track the drugs dispensed to each patient?

The system automatically tracks all of the information required by state and federal laws. The system allows the physician or office staff to immediately determine every drug dispensed or written to each patient. This is particularly valuable when the staff receives calls from local pharmacies. Prescription data is available at the "touch of a button", instead of the common practice requiring a staff member to pull patient charts.
22. Will the system track any products except drugs?

The DSI software program is designed to track, drugs dispensed in the office, prescriptions written, drug samples given to patients and virtually any other commodity the physician or office manager wishes to track (e.g., major med-surg supplies).
23. How secure is the system?

The system has a sophisticated password protection system build into the software. Each function performed by the software can be password protected according to the specific wishes and parameters of the office.
24. What if we have multiple practitioners in one office?

DSI's system can accommodate numerous practitioners per office. Each doctor is assigned his or hers own password as well as can assign security access to approved staff members who will be assisting in the dispensing process.
25. Must I use the DSI dispensing cabinets?

No, the cabinets have been designed to save space and to make the dispensing and drug storage process easier and faster. Drug can be stored in standard cabinets.
26. What hardware components make up the system?

The hardware consists of the hand held wireless device for the physician/PA/NP, a wireless local area network card (LAN), front office computer, monitor, keyboard, laser printer for reports and a special laser quality, small footprint, label printer for product and chart labels.
27. How much will I be charged for hardware?

The hardware for the hand held program is free to the physician. The hardware for the standard program costs approximately $800.
28. How much space does the hardware require?

The hardware requires approximately three square feet of space.
29. What type of Internet access is required for the hand held program?

The office needs to install a DSL line so the system is always on line. DSI technical support can also utilize this line to service the equipment properly, and to download non-patient specific data.
30. How do I solve hardware-related problems?

DSI maintains a technical support department to assist you in solving any hardware-related problems.
31. Will the system track my inventory levels?

Yes the system automatically tracks inventory levels. The individual office establishes inventory "par" levels during the initial installation (these levels can be changed at any time). The system automatically degrades inventory each time a product is dispensed to a patient. Reports are available to easily and quickly manage all aspects of the inventory.
32. How much inventory must I carry in my office?

DSI is capable of rapid product turnaround so a large inventory is usually not required. Most offices maintain at least a two-week supply of drug products. Most orders from DSI are turned around within 24 hours of receipt. Even if your office is on the East Coast, shipment times are rarely longer than five days.
33. How often will I be billed for the product DSI ships to my office and what payment terms are standard?

The hand held program automatically accounts for inventory sold every 10 working days and generates an approval form for the physician to approve the day before bank transactions take place. The system is designed to be the most time efficient and accurate accounting system even utilized for in office dispensing accounting. This system is the primary tool that allows DSI to provide all services virtually free of up front charges to the physician.
34. Can I select any drug I wish?

DSI has been in the in office drug dispensing industry for over ten years. Statistically 93% of all drugs dispensed are included in a formulary of less than 250 products. The hand held program requires participating physicians to chose from this highly effective formulary. DSI provides an additional 100 products for special uses that are also available to all participating physicians. As a licensed drug repackager, DSI can provide ANY drug that is shown to be cost effective for the practice. The standard DSI program has a much broader formulary for specific specialties. DSI believes the purpose of in-office dispensing is to maximize profitability for the practice while increasing drug product quality, safety, purity and patient convenience. The single most common reason for a non profitable program is selecting the wrong drugs for dispensing. The DSI program tracks ALL prescriptions written, so can easily and more accurately that ever before, determine EXACTLY the drugs a particular physician should dispense in-house and those that should be sent to a pharmacy. The DSI system is the ONLY system on the market that provides this level of inventory control to the physician virtually guaranteeing the most profitable program possible. The specific drug formulary of an office usually develops over time, and changes with seasonal and practice specific issues. Your DSI representative is always available to assist in formulary related issues.

35. Which drugs generally generate the greatest savings to my patients?

Typically high quality generic (AA or AB rated generic drugs are therapeutically equivalent to the brand name drug) drug products offer the greatest potential for patient cost savings.

36. Which drugs generally generate the greatest profit margins for my practice?

Typically high quality generic drugs (AA or AB rated, therapeutically equivalent to the brand name drug) offer the greatest potential for high profit margins in most physician offices.
37. How difficult is it to restock the DSI cabinets?

The DSI cabinet's load from the top and drugs are dispensed from the bottom. The cabinets guarantee fast, simple, and automatic first in, first out (FIFO) inventory control.
38. Who is authorized to perform the drug dispensing process in the office?

In the most highly regulated states, the physician, registered nurses, nurse practitioners, physician assistants or other licensed medical personnel. In medium to low regulated states, virtually any properly trained and managed employee working under an established standard operating procedure.
39. Will the system assure compliance to state and federal drug dispensing regulations?

The DSI system and DSI's FDA approved and labeled repackaged drug products virtually guarantee compliance to all state and federal regulations, so long as the process is completed per DSI's system requirements.
40. If a drug manufacturer has a product recall, will the system allow me to perform the recall process in an efficient manner?

One of the most important features of the DSI system is the ability to quickly identify patients that may have been given a product that is under recall. Most pharmacies do not have the capability to perform this important function. The DSI system does.
41. Why does DSI package penicillin and cephlasporin antibiotics in negative airflow packaging rooms?

According the FDA, penicillin and cephlasporin contamination of non antibiotic drug products cause up to 50% of all drug reactions in the US. It is virtually impossible to get any drug from a pharmacy that is not contaminated with penicillin/cephlasporin spore particles. One unit of penicillin can cause anaphylactic shock in a sensitive patient. One unit of penicillin is invisible to the naked eye. DSI packages these antibiotics in negative air flow packaging rooms to prevent cross contamination with these products.
42. If I have a question regarding and regulatory issue who do I call?

DSI has a Regulatory Affairs department to answer any of your legal or regulatory questions.

43. Which regulatory agencies have reviewed the DSI drug dispensing system?

DSI is registered with the Federal Food and Drug Administration, the Drug Enforcement Administration, the California FDA. JCOHA and many other private and public agencies have reviewed the system. In all cases the DSI drug dispensing/prescribing program meets or exceeds the standards established by each of these various agencies.
44. What level of customer service support can I expect from DSI and PIN?

DSI was founded on the principle of customer service. You can always count on DSI to deal with your service needs quickly, effectively and with the same level of concern you would give you're own business.

45. Can I expect a great deal of theft of product or other similar problems?

The DSI system manages the entire drug dispensing process such a way that theft is rarely a problem. If it occurs it is difficult to hide or accomplish easily with the system. Every container must be accounted for and the system reports allow the staff to easily and quickly determine if a problem exists.
46. How long does it take to get an order processed and shipped?

A typical order if received by 12 p.m. Pacific standard times, and if available in inventory could be processed and shipped the same day. All other orders are processed within 24 hours of receipt.
47. Can DSI provide special shipping and handling in emergency situations?

Yes DSI can handle emergency or special shipping requirements. Additional shipping charges may be added for special shipping requests.
48. Can I process drug refills with the system?

Drug refills can be tracked with the current version of the software. This function will be expanded upon in the future.

49. Can I accept drug co-pays for the products dispensed in my office?

Yes, in fact some of the most successful programs utilize the standard indemnity/HMO drug co-pays very effectively. Formulary development to accommodate the co-pay amounts common to an individual practice is an important factor in developing the offices drug formulary.
50. What percentage of the drugs I currently prescribe, should I dispense from my office?

The most successful offices typically dispense from fifteen percent (15%) to twenty-five percent (25%) of the drugs normally prescribed.

51. What profit margins can I expect to achieve?

If the office formulary is developed properly, most physicians never generate less than 100% profit margins on the drugs they dispense. Even at this rate, most prescriptions will be less expensive than they would be from a licensed pharmacy. The physician controls the profitability of the program. Some generate significant profit margins; others choose a more moderate type reimbursement program.
52. How do I determine the prices to charge for the drug I dispense?

The most typical method used to determine prices is to check with pharmacies close by the practice. The pharmacies cash price for a particular course of therapy is a good starting point in determining patient prices. DSI's sales representative is available to assist you in this process.
53. How much additional staff will I need to hire?

With a rare exception for very large practices (well in excess of 100 patients per day), no additional staff should be required to integrate and manage the DSI system in the office. What most offices find is that while there is some additional time needed to enter information in to the system, this time is more than made up by the reduction in phone calls from pharmacies, and other time spent that is currently part of the normal prescription drug program in every physician office.
54. How will my staff be trained on the program?

DSI will be responsible for training your staff to utilize the DSI system. New employees or employees not trained in the initial DSI program can be come familiar with the operations of the system with very minimal training from any other employee familiar with the system.
55. How do I determine my initial inventory?

The initial drug-dispensing inventory is determined in cooperation with a DSI's sales representative. DSI will supply you with drug formulary information (drug description, quantities, costs, etc.) and will work with you and your staff to determine those products you tend to commonly prescribe. This list of drugs will be used to determine the products that would best fit your individual practice patterns, profitability requirements, etc. During the first month or so, the formulary may change somewhat to best fit your individual patients needs.
56. Will I be dispensing both brand name and generic drug products?

The most financially successful point of care drug dispensing program typically utilizes a generic drug formulary. DSI provides physicians with virtually every drug product that is cost effective to dispense including, oral solids, suspensions, creams, lotions, suppositories, injectables, etc.
57. Can I dispense controlled substances with the system?

Yes the system is specifically designed to dispense controlled substances per all applicable DEA regulations. The office must supply DSI with a current DEA license appropriate to the drugs to be dispensed. The DSI system is designed to track all of these products more effectively than any other system currently on the market.