Brown Bagging and Hospital Pharmacy a Hazardous Combo?
In an attempt to save money, are people potentially putting themselves at risk? If you aren’t familiar with the term “Brown Bagging” for pharmaceuticals, it might seem strange. Like bringing your own lunch, Brown Bagging is the act of buying medication from a pharmacy or wholesaler and bringing them to a medical facility to be administered. With this practice comes a lot of questions and potential risks, not only to the patient but the hospital as well. First, we must better understand what “Brown Bagging” is and how it compares to “White Bagging.”
Taking a further look into Brown Bagging, it is a recent trend that has begun to show up nationwide in an attempt to save money on expensive medications. Since pharmacy and treatments are handled differently on most health plans, this has opened the door for people to utilize their prescription allotment separate from the treatment, which generally would include these medications, at the hospital. “‘Brown bagging’ is when a patient acquires specialty medication from a pharmacy and takes it to the physician’s office for administration. “White bagging” is when a physician receives a specialty medication from the pharmacy (on demand), and the patient visits the physician’s office for administration.” By separating where they receive their medication and treatment, patients can potentially save money and further utilize their health plan, but it leads to some serious questions.
The main question to consider is how is the integrity of the drugs being administered? Since the administering physician didn’t procure the drugs from start to finish, there is a possibility that they aren’t pure or could have been the wrong prescription. The risk behind this isn’t necessarily the fault of anyone, but drugs like “Biologic and other specialty drugs are complex to manufacture, prepare and dispose of, and include strict handling and storage instructions that patients may not be equipped to manage. Storage and handling become larger concerns when volatile drugs are delivered to patients through the mail, or if patients travel large distances to have the drugs infused.”
With this level of quality control being in question, it also leads to a higher risk for the administering facility and physician. By administering a drug that is not vetted by pharmaceutical staff and the physician, it opens the door for malpractice concerns and other potential legal issues. The American Medical Association currently doesn’t have a rule that directly relates to Brown Bagging, but Policy H-330.884 speaks to the administration of drugs as long as it is in the best interest of the patient, which brings up whether or not “Brown Bag” drugs are the best interest of the patients’ health.
The other side of this is also concerning. White Bagging is when the pharmacy or drug provider sends the medication directly to the hospital. The issue with this is that on occasion, the healthcare providers aren’t permitted to administer drug therapies to their critically ill patients and instead must direct their patients to seek care at unknown specialty pharmacies that are affiliated with the pharmaceutical provider. According to the AHA, “‘These policies — known as “white bagging” and “brown bagging” — serve no purpose other than enriching health insurance companies through their PBMs and specialty pharmacy business lines.” They further stated that “the policies should be heavily restricted and even banned.”
When comparing both sides of the story, it becomes apparent that much of what is going on is directly related to the rise in the cost of healthcare in the United States over the last few decades and is leading to potentially harmful outcomes. With the introduction of services like telepharmacy and AI integrated healthcare, these costs should start to decrease. Furthermore, this technology is available to the professional healthcare industry. It should be the responsibility of the professionally trained staff to procure, store, and administer these medications to ensure that they are as effective as possible. Overall the brown bagging/white bagging issue should be addressed so that medical professionals can provide the best care possible to their patients.
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