Direct Dispensing

What Are the Requirements to Dispense Medication Directly?

Direct dispensing of medication through a physician’s practice has become more popular as of late, but it’s still only being employed by a minority of private practices, urgent care clinics, and hospitals. By and large, the more popular way to provide a patient with their medication is by working with a pharmacist – the patient and the pharmacy receive the prescription, and the patient travels to the pharmacy to pick up their medication.

However, this has its drawbacks. For one, it can be difficult to ascertain patient compliance if you aren’t there to see them receive their medication. While pharmacists are responsible for helping patients better understand how their medicine works or why they might need it, circumstances don’t always allow for a comprehensive explanation. And while pharmacies work hard to ensure patients don’t take conflicting meds, it’s easier to check what your patient is taking when you have a better overview of what medication they’re buying.

Direct dispensing can help patients save plenty of time and energy spent visiting the pharmacy, especially when ill or under strict time-constraints. This furthermore boosts patient adherence, reduces overall waiting time and, as a result, helps improve patient outcomes. Implementing direct dispensing is easy, and quite simple – there are generally few requirements in the way, although these differ from state to state. While some states have serious restrictions in place against direct dispensing, most don’t, and some have none.

 

General Requirements

Any prescribing doctor knows that a DEA registration number is needed to begin prescribing drugs covered by schedules 2, 3, 4, and 5 controlled substances. But to sell these drugs, physicians and other medical professionals must typically get in contact with their state’s regulatory body for pharmacies, or the state’s medical boards, and receive permission.

Some states have no such requirements at all. Other states require a more rigorous approach. Depending on the state, registering to dispense medication at the point of care may cost a fee.

Below are important state-to-state details, as per broad specifications. For a more detailed account of which states feature which restrictions and requirements on the topic of direct dispensing, refer to the Prescribing Drug Abuse Policy System’s data, as well as data compiled in a survey by the National Association of Boards of Pharmacy.

 

Dispensing Regulations from State to State

States can be generally split between having no requirements, few requirements, certain restrictions, and total/near total prohibition. The states that have virtually no requirements or no requirements at all include:

  • California
  • Colorado
  • Connecticut
  • Delaware
  • Washington, DC
  • Hawaii
  • Idaho (nurses and physician’s assistants cannot dispense medication)
  • Iowa
  • Kansas
  • Kentucky
  • Maine
  • Michigan
  • Minnesota
  • Missouri
  • Nebraska
  • Ohio (dispensing doctors must obtain a state license to distribute controlled substances)
  • Oklahoma
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Vermont
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming

Most other states require registration through a state-specific organization, typically the Board of Pharmacy or the local Medical Board. These are usually very simple one-page forms, and there typically isn’t much keeping a reputable physician from obtaining the means to dispense controlled medication from their own office. States that require registration (and a varying number of requirements) include:

  • Alabama
  • Arizona
  • Arkansas (requires a permit)
  • Florida (requires a $100 fee and registration)
  • Georgia
  • Indiana (requires a pharmacy permit and a $100 fee, nurses and other listed healthcare professionals may apply)
  • Louisiana
  • Maryland (requires a detailed application, a list of requirements, and a $1,050 fee)
  • Mississippi (strict requirements for distributing scheduled drugs)
  • Nevada (licensing is required, and a $300 fee)
  • New Mexico (limited to repackaged medication)
  • North Carolina (annual fee of $75)
  • North Dakota (permitted with extensive requirements)
  • Oregon ($100 annual fee and registration)
  • Utah (very limited, with license)
  • Virginia (requires paid application, price varies between $180 and $240)

States that largely prohibit, completely prohibit, or prohibit direct dispensing with certain exemptions include:

  • Alaska
  • Massachusetts
  • Montana
  • New Hampshire
  • New Jersey
  • New York
  • Texas

It is simpler to obtain permission to dispense medication in some states than others. Among prohibited states, exemptions exist for patients who require immediate attention, or to greatly limit the supply physicians can dispense at any given time. There are typically fewer requirements in place for the dispensing of non-controlled substances, such as over-the-counter medication.

These rules are subject to change and can be challenged by local organizations and legal action. While they may be accurate at the time of publishing, you can inquire through a state’s official website, or through their Board of Pharmacy or Medical Board.

 

Implementing Direct Dispensing

The implementation of direct dispensing at a physician’s practice or private clinic is made easy through partnership with a dispensing solutions company, such as ProficientRx.

Sourcing the appropriate volume of medication while tracking patient information can be difficult and presents an additional burden to the practice. ProficientRx handles these tasks seamlessly by providing web-based software to help manage the logistics of dispensing medication directly to patients.

 

Who Benefits from Direct Dispensing? 

While the requirements to begin direct dispensing differ from state to state, and can be limited in some states, it’s worth the initial effort. The benefits of direct dispensing are convenience and safety for patients, and additional revenue for healthcare practices. Additionally, the ability to dispense and provide medication at the point-of-care eliminates the need to have a practice’s staff (or primary physician) on-hold with various pharmacies to place prescriptions, instead providing them with the time to otherwise better serve patients.

ProficientRx utilizes an easy-to-use web-based system to help physicians, hospitals, urgent care clinics and private practices carefully monitor patient information, keep track of dispensed medication, plan follow-ups, and more. ProficientRx works with clients to handle any and all practice sizes, and any medication volume. ProficientRx helps clients dispense all controlled substances (schedules II-V), as well as over-the-counter medication, vitamin supplements, and nutraceuticals. Brand and generic.

This dispense system is free of charge, with practices simply covering the cost of medication. Without any overhead, ProficientRx aims to help clients kickstart their in-office, point-of-care dispensing and help their patients immediately avail of the benefits of a comprehensive and well-structured direct dispensing plan.