Repackaging drugs works like this:

Every medication has a special identification number attached by the manufacturer. That number is used to identify the medication for cost and billing purposes by Medicare and Medi-Cal and other payers.

Medications are produced in bulk by manufacturers and repackaged for individual use by doctors' offices. Repackaging changes or eliminates the drug identification number, thus taking it off the fee schedule.

According to preliminary research done by CWCI and the Commission on Health and Safety and Workers' Compensation, some doctors charge between 400 and 700 percent more than what's charged at a pharmacy for the same medication.

CWCI research indicates that the repackaged drug Zantac goes for $255.56 for 150 mg. pills. At a pharmacy, the retail cost is $25.90. At Drugstore.com, the cost is $19.71. Repackaged pricing for naproxen (Aleve) and ibuprofen (Advil) were less than $255 but still more than the alternatives.

Zantac being the most prescribed and most expensive lends credence to the argument that doctors are dispensing medications that give them the most profit as opposed to those that truly help injured workers.

Repackaging is being marketed and encouraged by some companies as a way for physicians to make extra money. One such outfit, called Physicians Total Care (PTC), provides dispensing tools and discusses advantages of dispensing and how much money can be made, especially in workers' comp.

According to the web site, doctors can profit between $4 and $6 per prescription. "It will be on the low side for managed care patients and on the high end for cash-and-carry and workers' compensation patients," the web site reads. According to articles posted on its web site, doctors who use the PTC system to dispense drugs can make between $20,000 and $90,000 per year.