Price of Vicodin Three Times More in Maryland and Pennsylvania When Dispensed by a Physician
New studies from Cambridge-based Workers Compensation Research Institute (WCRI) says the average price paid for physician-dispensed Vicodin, a commonly dispensed narcotic pain medication in Maryland and Pennsylvania, was three times more than the price paid for the same drug dispensed at a pharmacy ($1.46 versus $0.37 per pill in Maryland and $1.22 versus $0.37 per pill in Pennsylvania).
According to the studies, the average prices paid to physician-dispensers were often more than double the prices paid for the same drugs dispensed at a pharmacy. Issues related to physician dispensing in Maryland have been debated, but no change has been made.
Physician dispensing has been growing rapidly in Pennsylvania. In 2011, physicians dispensed 23 percent of workers’ compensation prescriptions and were paid 38 percent of what was spent for all prescriptions for injured workers. This was an increase from 17 percent of all prescriptions and 18 percent of total prescription costs three years earlier.
“In many states across the country, policymakers are debating whether doctors should be paid significantly more than pharmacies for dispensing the same drug,” said Dr. 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.”
The Maryland study found that prices paid to physician-dispensers for many common drugs increased over the study period while prices paid to pharmacies for the same drugs typically decreased over the same period. For example, the average price paid for physician-dispensed Flexeril, a common muscle relaxant, increased by 16 percent in three years. Over the same period of time, the average price paid for the same drug dispensed at pharmacies decreased by 15 percent.
Prices paid to Pennsylvania physician-dispensers for many common drugs also increased over the study period while prices paid to pharmacies for the same drugs changed little or decreased. For example, the average price paid for physician-dispensed Vicodin increased 47 percent in three years. Over the same period of time, the average price paid for the same drug dispensed at pharmacies changed little at 2 percent. Similar patterns were seen for many common drugs.
The study also found that a number of drugs with over-the-counter strength were commonly dispensed by Maryland physicians at a higher price compared with the price at a pharmacy for the same drug. One such drug was Zantac, which costs about $0.35 per pill at Walgreens. However, when dispensed by Maryland physicians, the same drug costs $3.40 per pill.
The Pennsylvania study also found that a number of drugs with over-the-counter strength were commonly dispensed by physicians at a higher price compared with the price at a pharmacy for the same drug. One such drug was Prilosec OTC, which costs about $0.67 per pill at Walgreens. However, when Pennsylvania physicians dispensed the drug, they were paid an average of $7.43 per pill.
The data used for the Maryland report came from payors that represented 37 percent of the claims in the state workers’ compensation system. There were 16,860 claims included that had more than seven days of lost time with injuries arising from October 1, 2007, to September 30, 2011, and prescriptions filled through March 31, 2012.
The data used for the Pennsylvania came from payors that represented 41 percent of the claims in the state workers’ compensation system. There were 40,470 claims included that had more than seven days of lost time with injuries arising from October 1, 2007, to September 30, 2011, and prescriptions filled through March 31, 2012.
Source: WCRI