The practice of an external specialty pharmacy dispensing and delivering provider-administered medications directly to a health system clinic. White bagging often, but not always, shifts drug coverage and reimbursement from the medical benefit to the pharmacy benefit.

White bagging is a hot button issue for infusion care leaders. However, many leaders may not be seeing the full picture when it comes to white bagging’s impact on the infusion care landscape. Hospitals, health systems, and providers generally hold three viewpoints that tell only a portion of the story.

1. Health plans are using white bagging to pad their profits

Many health systems and providers consider white-bagging requirements an inappropriate attempt by health plans to influence clinical care and drive revenue to the health plans via pharmacy benefit manager-affiliated specialty pharmacies. However, this “us versus them” framework may limit providers’ consideration of the broader cost burden that provider-administered medications place on employers and communities, which pushes plans to implement white bagging requirements.

2. White bagging is an operational nightmare

White bagging requires additional resources while eliminating payment for pharmacy-related work. Finding space for new inventory, processing unused medications, and coordinating with external specialty pharmacies can strain clinics. However, by only focusing on the logistical challenges of white bagging, health systems may be missing opportunities to streamline these operational burdens to ensure high quality patient care.

3. Saying no to white bagging is our top priority

Many provider organizations have instituted “no-white-bagging” policies to prevent white-bagged drugs from entering their systems in any form. Health systems have increased their political advocacy efforts against white bagging on a state and national level. This strategy may be effective in creating long-term change, but it is unable to address the daily challenges of white bagging and can exacerbate the impact white bagging has on patients.