Prescriptions 300% higher at some doctors’ offices

Filling a prescription at a doctor’s office may be convenient, but it’s certainly no bargain for patients or taxpayers, according to an analysis of workers’ compensation payouts in Maryland and Pennsylvania.

The Workers Compensation Research Institute (WCRI) reviewed physician-dispensing prices in both states in 2011 and 2012. It found that physicians routinely charged patients prices that were three times as high as retail pharmacy prices. And even when the price of a particular drug was dropping throughout the marketplace, physicians charged patients rates that remained the same or increased.

“In many states across the country, policymakers are debating whether doctors should be paid significantly more than pharmacies for dispensing the same drug,” said Richard Victor, WCRI’s executive director. “One question for policymakers is whether the large price difference paid when physicians dispense is justified by the benefits of physician dispensing.”

In Pennsylvania, physicians dispensed 23% of all workers’ compensations prescriptions and were paid 38% of the total amount spent on scripts for injured workers in 2011 and 2012.

The WCRI review found that the average price for hydrocodone-acetaminophen dispensed by Pennsylvania doctors was $1.22 per pill. That same pill could have been purchased at a local pharmacy during that period for 37 cents per pill.

Additionally, the average price for physician-dispensed ibuprofen (Motrin) increased 15% in three years. During that same period, the average price paid for Motrin at pharmacies decreased 9%.

The review also found that drugs commonly dispensed by physicians in Pennsylvania were much less likely to be dispensed at pharmacies, meaning that doctors who did not dispense these drugs were less likely to write prescriptions for them.  Examples included naproxen sodium (Aleve) and omeprazole (Prilosec). And while the OTC price for Prilosec was about 67 cents per pill at Walgreens during the period examined, Pennsylvania doctors charged patients a whopping $7.43 per pill.

In Maryland, physicians dispensed 40% of workers’ compensation scripts in 2011 and 2012 and were paid 55% of the total amount spent on prescriptions for injured workers.

The WCRI review found similar price discrepancies. For example, Maryland physicians charged patients, on average, $1.56 per pill for tramadol HCl (Ultram), which was more than double what community pharmacies were charging during that period (60 cents per pill).

At physician offices throughout Maryland, the average price for cyclobenzaprine HCl (Flexeril) increased 16% in 3 years. During that same period, prices for Flexeril dispensed at pharmacies decreased 15%.