The American Society of Health-System Pharmacists (ASHP) is working to end a practice known as "white bagging," officials said.
White bagging is when a payer mandates that providers can only source drugs from a narrow selection of payer-affiliated specialty pharmacies. Under white bagging, health-system pharmacies receive these medications from specialty pharmacies that they must then dispense to the patients. Typically, under the buy-and-bill system, health system pharmacies maintain their own inventories and prepare medications according to electronic health records from physicians.
"We believe at ASHP that this jeopardizes patient care," said Kyle Robb, PharmD, a state policy & advocacy associate at ASHP, during a presentation at the society's Midyear virtual meeting. White bagging blinds clinicians and hospitals to drug supply chains, can cause delays in care, and compromises electronic medical records, he added.
"White bagging has really emerged and accelerated over the past couple years," noted Tom Kraus, MHS, vice president of government relations at ASHP.
In March, the ASHP and the American Hospital Association co-signed a letter to the FDA to call on the agency to enforce the Drug Supply Chain Security Act (DSCSA) -- which mandated that electronic supply chain histories must be kept for all prescription drugs until that drug is dispensed to the patient -- with the goal of ending white bagging.
"Our primary argument with the FDA is that white bagging fundamentally circumvents the DSCSA," Robb said. The DSCSA was passed in 2013 in response to a multi-state meningitis outbreak due to contaminated steroids made in a compounding pharmacy in Massachusetts.
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