Short version - we don't do them anymore. Longer version is below:
I'm a pharmacist with a respiratory certification and I started a respiratory DME with a pharmacy in 1999. At the time, respiratory meds were a big profit center - I used to joke with my pharmacist friends about dispensing the two or three most profitable Rx meds anywhere. We used to even call our oxygen patients to see if we could provide their neb meds.
Things changed as the drug payments and dispensing fees gradually came down, more in line with say, HMO pricing. What Medicare had been thinking with their old higher med fee schedule was beyond me. The meds then became a way to get the COPD patient earlier in their disease continuum to capture the more profitable oxygen business.
By 2006, we decided that with the quarterly price adjustments and dispensing fee changes, it wasn't worth it even for that. After all we were still getting the nebs, so we decided to use a mail order outfit for the drugs. We stopped dispensing, wrote our med patienst a letter and gradually turned them all over to the mail order pharmacy.
When Lincare bought the pharmacy and there were rumors they would be going after the O2 conversions, we dropped the mail order referrals. Now we let the MD arrange for the patient's meds - many of the retail chains now bill Medicare for the drugs.
We still get the neb and oxygen business and no one seems to care we don't do the meds. In this environment, you really can't give things away at no profit.
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