“White-bagging” dispensing refers to one of several ways specialty pharmacies help manage and distribute provider-administered specialty drugs. These are typically high-cost drugs, for example, infused oncology drugs, that require special handling and storage.
With white bagging, a specialty pharmacy ships a patient’s prescription directly to the provider, such as a physician office or an outpatient clinic. The provider holds the product until the patient arrives for treatment.
Interest groups including state hospital associations, health system pharmacists and individual hospitals are meeting with state boards of pharmacy and legislators to express concerns related to white bagging. They allege that this practice places patients at risk, creates medication integrity issues and limits provider control over ability to change dosing where necessary.
White-bagging opponents have created increased potential for legislation limiting or banning these practices altogether. For example, Louisiana recently passed a ban on white-bagging dispensing that went into effect June 1.
OptumRx believes that white bag dispensing has numerous benefits. These include improved access to drugs, improved affordability for patients and payers, timely delivery of medications in temperature-controlled packaging, and real-time claims billing. In particular we find that:
- Physician-administered drugs dispensed by a specialty pharmacy usually are for maintenance medications. Dosing is well-established and changes in the dosing are uncommon.
- Specialty pharmacies commonly contact the provider before dispensing. They confirm the dosage amount and clinical information that may affect dosage (e.g., blood test results, weight changes).
Why this matters: State legislatures are acting to prohibit or limit many of the tools PBM clients use to offer affordable pharmaceutical benefits to members. In many cases they may remove a safe and cost-effective option for Optum Rx clients, resulting in higher costs for clients and members.
Get involved: Our trade association is the Pharmaceutical Care Management Association PCMA. They work with our external affairs team to zealously advocate against changes that will negatively affect clients. However, legislators need to hear more than just the voice of the PBM industry. They need to hear directly from the clients who are impacted. If you are interested in learning how you can help advocate to protect members, contact your Optum Rx account management team.