A review of prescription pricing and a call for equitable payment

All of these systems are designed in order than a fair and equitable profit may be included for pharmaceutical services but this profit need not be excessive. For many years, the pharmacy has been considered a profit generator to offset the losses in other services departments. However, because of increased consumer awareness of prices and the close scrutiny of third party payers, including the federal government, this practice appears to be diminishing. With enactment of a comprehensive national health insurance, it is unlikely that the government will allow the type of cost accounting whereby one department generates profit to offset a deficit in other departments. Therefore, hospitals must develop a fair, equitable, and efficient pricing system. It is believed that the per diem charge system may be the most suitable for several reasons. First, it provides a mechanism for the charging of services not associated with the dispensing of pharmaceuticals. Second, this system appears to be more efficient because it eliminates the need to price individual prescriptions, which may result in an annual savings of $20 per bed as reported in one study. Third, the per diem mechanism promotes cost efficiency by focusing attention on the actual daily operating cost of providing pharmaceutical services. It is obvious that the general public is aware of the expense of health care, including pharmaceuticals. Hospital pharmacy has enjoyed a relative period of immunity from such public scrutiny for many years. We must, therefore, make every effort to encourage a pricing system that is equitable to both the hospital and the patient. In viewing these four mechanisms of payment, it is believed that the per diem rate for pharmaceutical services can and will be utilized to a much greater extent. When one considers its advantages along with the imminence of some form of a national health insurance program, this system appears to be the reimbursement mechanism of the future.