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A new study finds a growing number of workers who get hurt on the job are getting their medication directly from their physicians, instead of pharmacies, which is driving up costs.

For example, the cost of Vicodin is four times higher when it is dispensed by doctors instead of pharmacies, according to the study by the Workers Compensation Research Institute (WCRI).

The researchers analyzed 5.7 million prescriptions paid under workers compensation from 23 states, from 2007 to 2008, and from 2010 to 2011. During that time period, the average price per pill paid to doctors for Vicodin rose 78 percent, while prices paid to pharmacies fell by 8 percent, The Baltimore Sun reports.

“There is a great discrepancy between what doctors and pharmacies charge for dispensing the same drug,” Dr. Richard Victor, WCRI’s Executive Director, said in a news release. “One question for policymakers is whether the large price difference paid when physicians dispense is justified by the benefits of physician dispensing.”

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