The Benefits of an In-House Pharmacy

When it comes to making sure your rheumatology patients get the medications they need, there are a number of different options your practice or clinic can choose. Over the next several weeks, we’ll be discussing the pros and cons of some of these options, so that you can make the best choice for your business and the people you serve. To kick things off, we’re starting our series with an overview of in-house pharmacies.

Some rheumatology practices are beginning to offer in-house pharmacies as part of their practice, while others are wondering if this service is right for them. To help you decide whether an in-house pharmacy is worth the challenges, we’ve rounded up some of the benefits this system offers.


The health and safety of your patients is always your first priority, so it makes sense that one of the main benefits of an in-house pharmacy is to make it easier to for patients to receive the best possible care. The majority of rheumatology patients are older people, and many of them have to arrange for transportation to and from their appointments. By offering them the ability to get their prescriptions fulfilled while they’re at the clinic, you can save them an extra trip and make sure they’re able to take their medications on schedule.


Most of your patients are busy people with a lot on their plate. Offering them a “one-stop shopping” experience saves precious time and provides a service they’ll appreciate. It also makes it easier to make health a priority. According to a study published in the Journal of General Internal Medicine, between 28% and 31% of prescriptions are never filled. By offering an in-house pharmacy, you can help bring those numbers down for your rheumatology patients.


As rheumatologists, each patient you treat has unique needs, and having their prescriptions accessible and available when they need them is key to successful treatments and long term health. An in-house pharmacy means you have control over that availability, and that your patients will be able to get what they need, when they need it.


In some cases, an in-house pharmacy can be a source of revenue for your clinic. Depending on your state, you may be able to collect copays on prescription drugs and bill insurance companies for reimbursement. Your patients and/or their providers will have to spend this money anyway—they might as well spend it with you. That said, billing for pharmaceutical services is much different from than other medical services, and a practice interested starting an in-house pharmacy should consider seeking a pharmacy management company that would offer the ability to bill and manage the pharmacy, as this is full time job.


While in-house pharmacy can offer many benefits to your practice and your patients, we would be remiss in not mentioning a few compliance considerations.  Naturally, your in-office pharmacy would need to comply with any local, state and federal regulations regarding the storage and sale of pharmaceuticals.  Moreover, there are federal compliance issues to consider, namely The Stark Law. The Stark Law prohibits physician from referring Medicare patients to an entity with which the referring physician has a direct or indirect financial relationship, unless the referral falls within the defined exceptions to the law.  It may be wise to seek legal counsel to help you navigate this and other compliance regulations to protect your practice.

Ready to Go In-House?

As you can see, in-house pharmacies offer a number of benefits to your practice and for your patients. This solution is also particularly useful for rheumatic disease, as this condition is often treated with specialty medications, which allow the in-house pharmacy to remain focused on this specific care. If you live in a state where in-house pharmacies are legal and feel it would be a benefit to your patients, it may be time to implement your own in-house program.

If in-house pharmacies aren’t for you, or if you’re interested in other options, check back over the next few weeks, as we continue to discuss and explore the different avenues available to you and your practice.

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  • As a speaker at the first ad hoc meeting of rheumatology practice managers gathered in a single small room at its infancy a decade ago, I’m amazed to see how NORM has blossomed into a high energy organization of depth and professional meetings with parallel break-out symposia between plenary sessions. NORM has truly come of age. This is where the “business” of rheumatology gets learned. The ”guildmanship” for rheumatology practice management is now strong.- Paul H. Caldron, DO, FACP, FACR, MBA, Arizona Arthritis and Rheumatology Associates
  • In a time of demanding changes in the management of medical practices in the US, NORM has been a lifesaver to the community of Rheumatology practices.  NORM has allowed our practice to stay ahead of the many demands of CMS and others payors and has ensured that our practice remains cognizant of new issues that arise in HIPPA compliance, human resources and medical billing to name a few. Sending our Practice Manager to NORM's conferences has been cost-effective and beneficial to our practice because she returns to our office with an abundance of information that otherwise would have taken months to compile. Every Rheumatology practice that wishes to stay on top of emerging issues in practice management should consider sending a member of their staff to NORM's conference.- Michael S. Rosen M.D., Chester County Rheumatology PC
  • Thanks to all those wonderful people in the NORM Network who respond to emails, offering their advice, experience, time, and support ... I haven't even been a member a full year yet and I am amazed at the dedication of everyone who responds to helping via emails and the NORM Organization itself! I have barely had a chance to explore the resources and I have yet to really dive into requests for help still I am silently learning so much and do occasionally offer what I can! Thank you all!- Cheryl Piambino, Kenneth E. Bresky, DO

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