Introducing “Physician Dispensing” – The Latest Troubling Medical Industry Scam

Over the last two years, states nationwide have moved to crack down on so-called physician dispensing of prescription drugs, a practice largely limited to doctors who treat injured workers. But doctors and companies have responded by exploiting loopholes in those rules and adopting new strategies to stay one step ahead, recent studies suggest.

One tactic has been to create novel dosages of old drugs to get around cost controls on traditional ones, according to a report issued in January by the Workers Compensation Research Institute, a group in Cambridge, Mass. Along with the 7.5-milligram version of cyclobenzaprine, the muscle relaxant, new dosages of two older painkillers, tramadol and hydrocodone, that carry far higher prices than the standard versions, have also appeared, the study found.

– From today’s New York Times article: New Dosages of Old Drugs Are Used to Raise Their Prices

The main theme here at Liberty Blitzkrieg since inception has been that these United States, indeed much of the world, has become completely captured by a corrupt, greedy, ruthless oligarchy that has made itself entirely unaccountable, thus destroying the rule of law. In order to keep the racket going, the oligarchy relies on a minion class to support the power structure. Naturally, this minion class is generally too brainwashed, ignorant or stupid to even understand their place in the social structure, which makes them far more effective. Basically, “useful idiots.”

This class is also often given immunity from prosecution, which ensures that the worst rise to the top. Police fall into this category, which is partly why we have seen such insane criminality in recent years, ranging the gamut from extreme violence to outright theft. All of this has been happening as crime in America has been declining for decades.

The goal of the oligarchy is to corrupt as many useful idiots as possible, thus creating a culture of corruption so engrained it becomes virtually impossible to reverse. A great example of this relates to the plight of John Kiriakou, the only person imprisoned for CIA torture, because he was the one who blew the whistle on it. By creating these perverse incentives, you create a completely perverse society over time. The results are all around us.

Once the corruption reaches a certain level of societal saturation, you create a culture in which people simply stop trusting everyone and everything. For obvious reasons, this is a very dangerous development. There are people whom you need to trust for any civilization to function reasonably well. Police are one, but doctors are another. I can speak for myself when I say that I am not convinced that any medical professional I see has only my best interests at heart. I seriously wonder how he or she is balancing my health with the ability to earn more money. From conversations with friends and family, I have found that this is much more widespread than we would like to admit. This is incredibly bad and incredibly sad.

If you have any doubt as to why this is the case, all you have to do is watch the incredible video I posted yesterday: Video of the Day – John Oliver on Pharma Company “Marketing to Doctors”.

While that was bad enough, today I came across an article from the New York Times that will only further erode whatever trust still exists. Essentially, drug companies and doctors appear to be partnering to change the dosage levels for prescription drugs in order to avoid price caps. So instead of prescribing 5 or 10 milligram pills, they create a 7.5 milligram pill and charge multiples more per milligram. Perhaps I’m misunderstanding, but this appears to be the same as splitting your stock and claiming it creates shareholder value.

From the New York Times:

Doctors have long prescribed a muscle relaxant called cyclobenzaprine to treat injuries like back strains, using five- or 10-milligram pills.

But doctors who also dispense the drugs they prescribe directly to patients have recently embraced a new pill that contains 7.5 milligrams of the muscle relaxant. There is no evidence to suggest that the pill works any better except, perhaps, for doctors and the middlemen supplying them. They can charge $3.45, or about five times as much as a five- or 10-milligram pill.

Nice, so basically doctors have learned from Wall Street. Essentially splitting dosages, repackaging them and earning more money. “Try this new synthetic cyclobenzaprine dosage Mr. Smith, AAA rated too!”

Over the last two years, states nationwide have moved to crack down on so-called physician dispensing of prescription drugs, a practice largely limited to doctors who treat injured workers. But doctors and companies have responded by exploiting loopholes in those rules and adopting new strategies to stay one step ahead, recent studies suggest.

One tactic has been to create novel dosages of old drugs to get around cost controls on traditional ones, according to a report issued in January by the Workers Compensation Research Institute, a group in Cambridge, Mass. Along with the 7.5-milligram version of cyclobenzaprine, the muscle relaxant, new dosages of two older painkillers, tramadol and hydrocodone, that carry far higher prices than the standard versions, have also appeared, the study found.

“The regulations stimulated this innovation,” said Richard A. Victor, the executive director of the research group, which is financed by insurers and state governments.

If this is what we consider “innovation” in America today, we are in very big trouble.

Along with the new drug strengths, doctors are finding ways to generate added income by dispensing medical foods and compounded drugs, other studies show.

Here’s the thing, as long as this continues, all sorts of other “innovations” will suddenly emerge. Some of them will undoubtably be harmful to patients if the profit incentive is big enough.

A number of states, including Florida, Pennsylvania and Indiana, have adopted rules tying the price of a drug dispensed by a physician to a benchmark known as the medication’s “average wholesale price.” The rules vary, but they typically allow the cost of a physician-dispensed drug to reflect a small markup above the medication’s “average wholesale price.” Some states do not allow any markup, but permit a doctor to charge a modest prescribing fee.

Mr. Victor said that staff members at the Workers Compensation Research Institute, while reviewing data for another project, stumbled over information indicating that entrepreneurial doctors and companies had responded with new strategies. By producing a novel dosage, a manufacturer could also create a new “average wholesale price” for that dose that bore little relation to existing forms of the drug and could be many times higher.

Meanwhile, another recent study by a consulting group, CompPharma, found that doctors treating injured workers were increasingly using compounded medications, such as specially prepared topical creams to treat pain containing various drugs and ingredients. There is little evidence such preparations work, the consulting group reported.

If we can’t trust our doctors to do the right thing, who can we trust?

For related articles, see:

Video of the Day – John Oliver on Pharma Company “Marketing to Doctors”

How Doctors Prescribing Meds Based on Drug Company Payoffs is Further Evidence of Systemic Failure

Fraud Alert: FDA Allowed Drugs with Fraudulent Testing to Remain on the Market

Deaths from Prescription Drugs Now Exceed Those Related to Cocaine and Heroin Combined

How a $1 Bag of Salt Water Becomes a $546 Bill at Hospitals

Americans are Now Traveling Overseas for Surgery

In Liberty,
Michael Krieger

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