US hospitals spend $310M per year on pharmacy white & brown bagging requirements, analysis finds

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U.S. hospitals spend an estimated $310 million annually on managing "white bagging" and "brown bagging" requirements for specialty pharmaceuticals, according to a report Vizient released Aug. 30.

Through white bagging, private payers don't allow providers to procure and manage a drug for their patients, but rather require a third-party specialty pharmacy to dispense the drug to the provider. Brown bagging is similar to white bagging, but the specialty pharmacy sends the drug directly to the patient, who brings it to their provider.

The report included a survey of 260 hospitals, conducted in March and April. It found that hospitals have already spent an estimated $114 million on additional staff to manage the clinical, operational, logistical and patient care work associated with white bagging. It also found that 95 percent of hospitals have not quantified the waste their organization is facing due to white and brown bagging.

Ninety-two percent of respondents said they've experienced problems with the medication received through white and brown bagging, with 83 percent saying the medication did not arrive in time for administration to the patient and 66 percent saying they received the incorrect dose due to the patient's treatment course changing before arrival.

Ninety-five percent of respondents said they've experienced operational and safety issues due to white and brown bagging, such as separate inventory management systems, delivery location/security disruptions and lack of space to hold medication.

"White bagging delays care for patients who need real-time dose adjustments to ensure the best outcome. If 66 percent of people say they have received the incorrect dose for their patients, that's a real problem," Erin Fox, PharmD, senior director of drug information and support services at University of Utah Health in Salt Lake City, said in the report.

In March, the American Hospital Association called on policymakers to prohibit the use of brown bagging, and to stop the use of white bagging when prescription doses are dependent on lab results, among other instances.

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