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Dispensing Pharmacy: An Option for Private Practices
Providing insight into the decision-making process and challenges involved in setting up a dispensing pharmacy.
ACCC surveys show that many practice members seek to better understand the issues associated with opening a dispensing pharmacy within a practice. As more oral anti-cancer drugs come into widespread use, will opening a dispensing pharmacy in an oncology practice enhance patient quality of care? What metrics can be used to determine whether or not to implement a dispensing pharmacy in a practice? ACCC seeks to answer this question and provide insight into the decision-making process and challenges involved in setting up a dispensing pharmacy with its educational program, Dispensing Pharmacy: An Option for Private Practices.
Objectives:
- To describe components of a dispensing pharmacy and provide information about new oral and IV anti-cancer treatments.
- To develop metrics that practices can use to determine whether starting a dispensing pharmacy is in the best interest of their particular practice and their patients.
- To provide tools to measure whether patient care is enhanced by having a dispensing pharmacy in the practice.
Interviews:
In the first part of its educational program, ACCC conducted interviews with practices that have opened dispensing pharmacies, as well as practices that have chosen not to open a dispensing pharmacy. Here are key findings from those interviews.
Practices That Dispense Medications—What They Said
- Most oncology practices used an outside consultant (such as ION or US Oncology) to conduct a formal evaluation to decide whether or not to establish an in-house dispensing pharmacy. Interviewees stated that they are constantly evaluating whether the decision made was the right choice.
- Oncology practices are not seeking a significant profit with an in-office dispensing pharmacy, but rather hope to generate revenue to cover uncompensated costs (financial planners, nurse calls, patient education) as well as provide patient convenience. All interviewees were either breaking even or making a profit on their pharmacy. These profits ranged from small to significant depending on how long the pharmacy had been in operation.
- Interviewees did not believe that having an in-office dispensing pharmacy altered practice prescribing decisions.
- Oncology practices believed that having an in-office dispensing pharmacy has given them a competitive advantage over other practices in their areas.
For Practices that Do Not Dispense Medications—What They Said
- Most oncology practices used an outside consultant (such as ION or US Oncology) to conduct a formal evaluation to decide whether or not to establish an in-house dispensing pharmacy. Interviewees stated that they are constantly evaluating whether the decision made was the right choice.
- The decision to not open an in-office pharmacy was based on three key issues. First, oncology practices were concerned with staffing. Many state laws would require practices to hire additional staff. Even if no additional staff were needed, oncology practices were concerned that current staff would be unable to handle the additional workload involved in dispensing medications. Second, oncology practices were concerned about reimbursement. Specifically, interviewees were concerned that certain payers would not allow patients to use the office’s pharmacy and instead require patients to use a payer stipulated “network” pharmacy. Finally, oncology practices expressed concerns about the lack of margins on oral anti-cancer medications.
- Most oncology practices interviewed were not very familiar with the laws that surround in-office dispensing pharmacies.
- Interviewees believe that a lack of an in-office pharmacy has not resulted in any inhibition of access to medications for patients; however, some practices noted that this may be an issue in smaller markets.
- Oncology practices cited the following reasons they might change their decision to establish an in-office dispensing pharmacy: 1) finding a good model they could replicate, 2) receiving larger margins on orals in the future, and 3) identifying pharmaceutical companies willing to do the patient follow-up required for oral oncolytics to ensure patient compliance.
Final Report:
If you have any comments about this project, we would like to hear from you.
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