| | | | History of Dispensing
| Physician Dispensing Then and Now… 1980's to 2001
1980’s
The practice of physician dispensing reemerged as an industry in the early 1980’s with the introduction of repackaged drugs. The process was spearheaded by a number of pharmacist entrepreneurs who began to pre-package drugs for local physicians.
By 1985 over 37 regional based small companies were marketing pre-packaging services across the country.
In 1983 the retail pharmacy industry began an extensive nationwide campaign to eliminate every physicians right to dispense medication. By 1985, repackaging industry leaders were able to pass legislation in the US Congress and in 46 states; securing the physicians right to dispense FDA approved medication to their own patients. In addition, the Stark II legislation identified physician dispensing as an acceptable practice if limited to the physicians own patients, and if the products dispensed complied with FDA packaging and labeling requirements.
THE GOOD - Once the legislative issues were resolved, the industry grew very rapidly as physicians began to realize the safety, convenience, cost effectiveness and tremendous profit potential of physician in-office dispensing.
THE BAD - As the small regional re-packagers began to grow in size, the FDA and other state agencies began to push for more and more compliance to federal packaging and product labeling requirements. Many of the small re-packagers could not cost effectively comply and stay in business. By the end of the decade only 8 major players were left in business. These re-packagers provided less than 300 products for dispensing.
1990’s
In the early 1990’s the re-packagers that were still in business, had established the significant benefits of in-office dispensing both from a patient safety standpoint and the physicians profit standpoint. Systems were well established to make the dispensing process, fast, simple, and cost effective from the physician's point of view. Unfortunately, because the drug repackaging industry had no accurate method to truly track a physicians actual prescription writing habits, no methods existed to easily understand or determine the most cost effective drugs to dispense. As a result, re-packagers began to get requests for more and more line items. By 1995, the average repackager was being forced to package over 5000 different line items even though less than 300 made up 93% of the average company's entire sales volume. This process significantly drove up costs because re-packagers were destroying over 50% of the line items they packaged. A physician would order an item one time then never order that item again and the product would eventually expire and have to be destroyed.
THE GOOD - During the 15 years following the Stark II legislation, tens of millions of repackaged drugs were dispensed to patients nationwide. Not a single fatality has been recorded during this time that could be attributed to re-packaged drug products. This level of safety simply cannot be duplicated in a pharmacy, regardless of the methods employed to reduce errors.
THE BAD - Repackagers profitability began a rapid decline because they were being forced to package over 5000 different line items when 93% of their business was focused on less than 300. More and more re-packagers were forced out of business reducing the number of choices to the physician, eliminating competition within the industry and increasing costs to physicians. Systems simply did not exist to provide the tools necessary to truly maximize profitability for the physician and minimize costs for the repackager.
Today
In the last year, technology has finally caught up with the drug repackaging industry. DSI is the first drug repackager to develop a complete system that takes full advantage of the new hand held, completely wireless PDA systems for prescription writing. Utilizing this technology, eDispense™ has developed a program that provides each physician with a palm device for writing electronic prescriptions (expected to be mandated within the next 2-years), and that incorporates the most sophisticated in-office dispensing program available. The eDispense™ provides the physician with the ability to electronically generate four types of transactions at the touch of a button. Every prescription is written with the PDA, the physician determines if the prescription will be dispensed in-house for a profit, printed for signature and given to the patient, electronically faxed to a local pharmacy or mail order. Every transaction is recorded, providing DSI with the information necessary to maximize the physicians profit, adjust the physicians in-house inventory on a weekly basis, and provide the hardware, software, ongoing upgrades, system maintenance and drug products at absolutely no upfront costs to the physician. The eDispense provides profitability, and complete prescription monitoring and control in partnership with the physician, decreasing errors & costs while increasing compliance and convenience.
| | |
