IRVING, Texas (BUSINESS WIRE), August 30, 2021 - Vizient, Inc. released a survey analysis today which estimates U.S. hospitals are spending $310 million annually to manage the additional clinical, operational, logistical, and patient care work associated with white and brown bagging requirements, which impact the way specialty pharmaceuticals, used to treat diseases such as cancer, are dispensed. The survey included responses from 260 hospitals obtained between March and April 2021 and shows that due to these payer-imposed mandates, hospitals have already spent an estimated $114 million on additional staff to manage the excess coordination associated with white bagging.

Recent payer-imposed policies have forced the shift for many physicians and health systems from a traditional buy-and-bill model, where the provider purchases the medication and dispenses or administers it to the patient, to one known as white bagging where the physician receives a specialty medication from an external pharmacy (on demand) and the patient visits their physician's office/outpatient infusion center for administration. Brown bagging is when a patient acquires their medication from an external pharmacy and takes it to their provider for administration. These changes to dispensing policies complicate access and creates delivery and dispensing delays impacting speed to therapy for patients, possibly resulting in negative outcomes and more financial burdens.

“White and brown bagging is causing staffing resource challenges and increased expense for hospitals at a time when COVID-19 has already caused significant hardships,” said Dan Kistner, PharmD, group senior vice president, Pharmacy Solutions for Vizient. “Beyond those challenges and hardships, it’s impacting the crux of what hospitals do: provide patient care. This can cause patients who require chemotherapy medications and other critically important drugs to experience gaps in care coordination that result in delay in treatment.”

Additional key findings include:

  • 92% of respondents experienced problems with the medication received through white/brown bagging including issues such as wrong drug, damaged product, dose not arriving in time for administration, and dose no longer appropriate due to patient's therapy changes.
  • 95% of respondents experienced operational and safety issues associated with white/brown bagging. The issues encountered included: separate inventory management system, delivery location/security disruptions, lack of space to hold medication (e.g., refrigeration), etc.
  • 52% of respondents do not have an established policy in place in attempt to prohibit white/brown bagging.
  • 56% of respondents have not developed educational materials on the impact of alternate channels and their effect on the hospital.

“The reality is that this may simply be the tip of the iceberg, as most hospitals have not taken the steps to quantify the financial impact white and brown bagging have had on their institutions,” said Kistner. “As hospitals navigate this complex issue, they must develop a strategy to evaluate the extent of impact to their organization and their patients, educate their financial and managed care leaders, and advocate for legislative reform for themselves and their patients.”

The full survey results can be accessed here:

About Vizient
Vizient, Inc. provides solutions and services that improve the delivery of high-value care by aligning cost, quality and market performance for more than 50% of the nation’s acute care providers, which includes 95% of the nation’s academic medical centers and more than 20% of ambulatory providers. Vizient provides expertise, analytics and advisory services, as well as a contract portfolio that represents more than $100 billion in annual purchasing volume, to improve patient outcomes and lower costs. In 2021, Vizient acquired Intalere, which expanded its footprint with ambulatory and rural acute care providers. Vizient has earned a World’s Most Ethical Company designation from the Ethisphere Institute every year since its inception. Headquartered in Irving, Texas, Vizient has offices throughout the United States. Learn more at


Donna Ledbetter
(972) 830-6321