Experts Vary on Challenges, Benefits of White Bagging

As health plans seek to have more control over their spending on provider-administered specialty drugs, many physicians are pushing back, as seen most recently with BlueCross BlueShield of Tennessee’s (BCBST) new program (see story, p. 1). But at least one survey of commercial payers shows that mandating the use of a specialty pharmacy to acquire these therapies is replacing the longstanding approach, a trend that respondents anticipate will continue even though industry experts vary on the benefits and challenges of such an approach.

Providers traditionally have acquired therapies they administer through a practice known as buy and bill, by which they will purchase a drug from a wholesaler or distributor, keep it in their office and administer it to patients as needed, submitting a claim to the payer afterwards. Through this approach, providers can make a profit by marking up the drug.

© 2024 MMIT
Angela Maas

Angela Maas

Angela has an extensive background of editing, reporting and writing for trade and consumer publications. She has written Radar on Specialty Pharmacy since she joined AIS Health in 2005 and has broad knowledge of the various issues at play within the space. She also has written for Spotlight on Market Access since its 2017 launch. Before joining AIS Health, she was managing editor at Employee Benefit News and Employee Benefit News Canada and managing editor at Hem Aware (a hemophilia publication), Lupus Living and Momentum (a multiple sclerosis publication). She has a B.A. in English and an M.A. in British literature from Arizona State University.

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