If physicians have the licensed expertise to prescribe a drug, shouldn’t they be able to sell it to the patient they personally care for? Most states agree, yet Texas is one that continues to say no. In allowing physicians to dispense medication—as do 45 states already—the patient is prioritized.
Not only would this make drugs more accessible and understandable to the patient, they’d also be cheaper. Physician dispense cuts out the middlemen involved in the pharmaceutical supply chain called pharmacy benefit managers, which work hand-in-hand with insurers.
There is a direct relationship between our nation’s increasing drug costs and PBM’s “cut” of the sales as they drive up the cost of medications dispensed by pharmacies that they are tied to. If the patient can get this same drug directly from their physician, “cash-only” with no interference from insurance fees, then medication costs would significantly decline for the patient. So, if there is a cheaper alternative available, the power should be in the hands of the patient to choose it.
Giving the patient flexibility to decide how they receive their medication will not only allow for more affordable options to choose from, it will also improve the doctor-patient relationship and build patient’s trust in how their health is handled. Rather than receiving prescriptions from a faceless mail-order dispenser (which is becoming more and more prevalent through various insurance plans), patients are in the driver’s seat.
On a daily basis, patients experience a disconnect between their prescription order and it being ready at the pharmacy. This is critical with time-sensitive drugs. These aren’t necessarily the kinds of drugs you might take regularly; they are more likely the drugs you need when you or your child has strep throat or an ear infection. They are the kind that will provide relief for your sinus infection or nausea. They are the ones you might just skip out on if the pharmacy is too far away or getting your child there is too impractical, even if they will provide the relief you or your loved one desperately needs.
Incentivizing patients to take their medications as prescribed to them is key. Currently, 30% of prescriptions are not filled, and 50% of patients don’t properly adhere to their prescription instructions.
Allowing patients to purchase medication at the point of care can alleviate these gaps. Mail-order pharmacies do not include the timeliness and knowledge our physicians can provide us in-office with the medications they distribute. Physicians, along with pharmacist partners, can explain the prescription’s implications, side effects, and importance of taking it to its full extent better than mail-order or disconnected pharmacists who do not have a constant role in the patient’s care. Point-of-care dispense strengthens the personal relationship we have with our physicians through better communication.
This is not to diminish the pharmacist-patient relationship that some small town or independently owned pharmacy providers have with their customers. But that is not the reality for the majority of people. For most of us, when the doctor asks whether our preferred pharmacy is H-E-B or CVS, our response is not based on their relationship with the pharmacist but rather the distance to our homes.
Physician dispense would allow for patients to decide if they want to cut out that additional step and pay their physician for their prescription directly instead. Direct point-of-care dispense allows physicians and patients to work around the steep prices imposed by these intermediaries.
Why are we prioritizing the insurers and other middlemen when we should be prioritizing the patient’s health by offering options for affordable medication? If a more affordable, more patient-focused alternative of medication dispensing is possible, why are we not adapting? Change can be made to put the patient first by allowing the dispensing of medication by physicians at the point of care.