Office-based dispensing is an option that increasingly is being considered by pediatricians. Interest in this service is shared by other ambulatory health care providers as well. Dispensing is not new to American medicine; physicians have been providing medications for purchase by patients for decades. Until recently, however, the service has been largely limited to rural and special practice situations. Only in the past few years has dispensing been exercised as an option in more traditional practice situations.
Current estimates indicate that the 5% of actively practicing physicians who dispense medications actually provide only 0.01% of total retail drug sales. Nonetheless, the practice appears to be increasing, as is made evident by recent, rapid growth of the drug "repackaging" industry that prepares units for in-office resale. So, too, has grown the controversy hat presently focuses on both the necessity and propriety of dispensing by office-based physicians.
The physician's decision to dispense medications, where legally permitted, must be a personal one. However, factors that necessarily impact this decision include patient needs, quality issues, practice characteristics, and community considerations. This statement is intended to assist the pediatrician to make an informed analysis of these issues.
Presently, medication dispensing is permissible in all states. However, several states have restrictions that allow physicians to dispense in rural areas only (Montana, Texas), supply until the patient is able to have the prescription filled at a pharmacy (Massachusetts, Texas), dispense in emergencies only (Montana, Utah), and comply with other restrictions (West Virginia, Montana, Virginia, Nebraska). In most states, physicians must meet additional requirements to be able to dispense.
- Copyright © 1989 by the American Academy of Pediatrics