Tag Archives: in-office prescription dispensing

Dispense Controlled Substances | Proficient Rx

Requirements to Dispense Controlled Substances

As a physician who wants to dispense controlled substances, you must follow both state and federal laws. When your state laws are different than the federal laws, you are required to follow the most stringent rules. Meaning, if you state laws are stricter than the federal laws, you must follow state rules.

Federal laws are often the least strict of the two. For example, federal law does not limit the length of time a prescription is valid, but most states have a six-month limitation.

Drug Enforcement Agency Requirements

You can dispense schedule II through V class of drugs only and you must follow all Drug Enforcement Administration rules strictly.

The Drug Enforcement Administration makes it clear that when you dispense a narcotic of any kind, it must be for a legitimate medical reason. You must make sure it meets all the regulations showing it is valid. In addition, you must verify all information on the drug to make sure it corresponds with the patient.

This means you must verify the patients name, dosage, drug being prescribed, strength and quantity before you give it to your patient.

Every few years you must register with the Drug Enforcement Administration (DEA) to dispense controlled substances.

State Board of Pharmacy Regulations

You must be licensed by your State’s Board of Pharmacy to dispense controlled substances. Once approved, you must follow their prescribing regulations.

Such regulations make it very aware that Schedule III and IV controlled substances cannot be prescribed more than five times or for more than six months after the initial date of prescription. A new prescription must be written if needed after the six-month limit.

Refills are prohibited under DEA regulations.

In addition, you must check the prescription drug monitoring program when verifying prescriptions.

Prescription Drug Monitoring Program

Governments have established programs called the prescription drug monitoring program to help physicians verify whether or not a patient has been listed as an abuser of certain drugs. This monitoring system has been a terrific way to prevent patients from doctor shopping for someone to dispense controlled substances .

Doctor shopping has been used for years by addicts who try and manipulate physicians to get prescriptions for narcotics.

Documentation Requirements

One of the most important regulations when you dispense controlled substances is to keep good records. You must document everything about your prescription and dispensing practices include who is receiving the drugs, why they are receiving them and why they are necessary.

Packaging and Labeling Requirements

Controlled substances must be contained in secure packaging to avoid contamination of the medicine. Packaging much also be child-resistant to avoid any potential accidents. Controlled substances labels must be detailed and list the patient’s name, address; phone number and reason for use.

They must also list potential hazards, warnings and the prescribing doctor’s name.

Dispense Controlled Substances In An Emergency

There may be times when your patients need immediate assistance. You can dispense controlled substances in these urgent situations. However, you must be able to prove it was an emergency and that no other form of treatment was available.

The drug you prescribe must also be limited to the treatment time. Meaning, you cannot continue to provide controlled substances to your patients after the emergency, unless you write a prescription for it.

Partial Dispensing

You may not always have the exact number of controlled substances on hand to fill a complete order. In these situations, you can fill a partial prescription. The remaining medicine is to be picked up later.

Partial prescriptions must be documented as such, along with detailed descriptions of why the medicine is only partially prescribed. Include information about the patient as well. If they are terminally ill, mark that information on the prescription.

Dispensing Without a Prescription

Believe it or not, there are conditions under which you can dispense controlled substances without a prescription. The specific details are outlined in the regulations handbook.  The regulations state you cannot dispense more than 8 ounces of any opium related product, and 4 ounces of any other controlled substances.

You only have a 48-hour period in which to dispense a controlled substance. This means that if you patient needs an opiate for pain and you do not have a prescription written, you can give them a maximum of 8 ounces in a two-day period.

Provide Information on Treatment for Controlled Substances

Your duty as a doctor is to protect the well being of your patients. Prescribing opiates and other addictive medicines is part of your duty. Patients are in pain and you can help them by easing that pain with medication.

There is nothing wrong in doing this. However, some of your patients will take advantage of your duties. This happens when patients become addicted to their medicine.

If you find one of your patients is addicted to their medication, it is then your duty to provide them with information on how to break their addiction.

Being addicted to narcotic can quickly lead to damaging mental and physical health of your patient. As you know, their tolerance to the medicine you prescribe grows quickly. Soon, a patient you were able to help in the beginning with pain, becomes a patient you dread seeing.

You know they are only seeking more controlled substances to feed their addiction. They will go to great lengths to maintain their addiction, including doctor shopping. Checking the national drug registry and any in-state programs you have access to that can tell you about your patient’s drug history.

As their doctor, it is up to you and your staff to introduce treatment options. They may refuse it, but that is okay. You simply need to provide them with the right information, so they can obtain help when they are ready.

If you feel their life is in danger due to their abuse of their prescriptions, you can make the referral to a treatment facility. You have the authority to recommend hospitalization for them if you feel it is needed.

The most important thing to remember is don’t forget to document everything. If it is not documented, it did not happen.


In-Office Prescription Dispensing | Proficient Rx

The Benefits of In-Office Prescription Dispensing Over Pharmacies

According to the Center for Disease Control, 2.8 billion drugs were ordered or provided for patients in 2013 and these numbers continue to rise. Of the people visiting a physician, 74% involved drug therapy.  In-office prescription dispensing has been gaining ground, but traditional pharmacies still provide the bulk of these medications to people in need.

This means close to three billion prescriptions leave a physician’s office and head straight to a pharmacy per year. The pharmacy fills the prescription and dispenses it to the patient.

This also means millions of patients leave their physician’s office and drive, sometimes many miles, to the nearest pharmacist. Many go to big box pharmacists for the cheaper prices. But this does not give them the best experience.

Better Patient Experience

Patients can sometimes wait hours for their prescription to be filled by a pharmacy. With only a couple of pharmacists on staff, one of the numerous pharmacy technicians are providing service to your patient.

If your patient has a question about his or her prescription, they wait for the pharmacist, who is already bogged down, to speak with them. While pharmacists are excellent at what they do, they just don’t have the time needed to dedicate to each customer.

Many pharmacists are burned out.

It is rare to meet a pharmacist with time on their hands. They are constantly filling the hundreds of orders received throughout a day. If your patient has questions about their medicines, it is unlikely they can receive a private consultation.

Some patients do not feel comfortable asking a pharmacist for help due to the line of people waiting behind them, because they must ask their questions publicly, or because they see their pharmacist as a stranger.

On top of that, pharmacists make more mistakes when filling prescriptions under stress and an overwhelming workload.

This is not the experience you want for your patients.

In-office prescription dispensing can eliminate all these problems and more.

What is In-Office Prescription Dispensing?

In-office prescription dispensing gives you the opportunity to provide your patients with a value-added service. It is simply a mini-pharmacy located right there in your office.

There are different models you can opt for when setting up this system. You can choose a simpler model that allows you to fill the prescriptions. Or, you can choose a larger model that allows you to hire a pharmacist part-time or full-time, or a pharmacy technician, to fill the prescriptions.

The ability to dispense medicines in your practice offers your practice many rewards.

Benefits for the Physician

For you, the physician, in-office prescription dispensing means extra money. By adding a section of your office devoted to prescribing medicines, you can establish another source of income for your practice.

Satisfied patients are a benefit you will notice quickly upon establishing an in office dispensing system. Patients will appreciate your efforts to make their lives easier. You are offering them convenience.

This is a big deal when someone has an illness causing them pain. The last thing they want to do is travel to a different location and wait, feeling sick, for a prescription.

When you provide private, quick, in-office prescription dispensing services to patients, you are likely retaining your patients and giving them reasons not to leave your practice for another.

As a physician, you rely on your patient’s word when determining if they are abusing their medicine in any way. By having an in-office dispensary, you can have a better understanding about your patient’s medicinal routines.

You can see if they are calling in for early refills or not picking up their medicines at all.

The benefits for your patients are just as numerous.

Benefits for the Patient

Your patients take medications based on your professional expertise. They trust you. Because you have direct contact with the pharmaceutical representatives, patients can feel good that you are completely knowledgeable about the medicines they are taking.

Patients may benefit the most by being able to access their medicines in a shorter amount of time. Some of your patients must arrange for transportation, often a difficult and sometimes costly task. In-office prescription dispensing will eliminate this barrier.

Your patients will feel more comfortable talking to a staff they already know, not a stranger at the pharmacy. They will be more likely to ask questions and reveal if they are having any issues with their medicines.

The cost of medicines can be more affordable when dispensed in-office. This is because you can search and find your patients the best deal, making this service very popular.

You are probably thinking this sounds great so far but are wondering if it is difficult to establish. It is not.

Benefits of Getting Help with Set-Up

Believe it or not, adding an in-office prescription dispensing system to your practice is not as difficult as you may think. There are companies who can help you through every step of the process. Or, you can move ahead on your own, following established guidelines.

Making sure it is legal in your state is the most crucial step. Not all states allow doctors to practice in-office prescription dispensing. But if you are allowed, the next step is to simply make sure you meet all the laws and regulations attached to having a dispensary.

Determine which type of insurance policies you need to cover your practice, the size of your inventory, how you will keep records and how the medicines will be dispensed.

Once you are following the regulations, you can begin dispensing. Many choose to use pharmaceutical companies that can provide you with prepackaged medication. This saves you time and effort.

Using a company that specializes in setting up in-office prescription dispensing within a practice offers you great benefits. Specifically, they can provide you with software that can easily process and send claims to insurance companies, credential staff with insurance companies and ensure you are in compliance with the state.

The money you will spend on a company to help with setup is reportedly recouped within six months or less. The space it takes is minimal, there is no need to add on to your facility. The program works great for one physician practices as well as large group practices.

Having in-office prescription dispensing could also be a stepping stone for expanding your practice into several other complementary areas. In the end, it can give you a great start to meeting many of your professional goals.