April 11, 2007
Talk About the Cost
In the November 2006 issue of the American Journal of Managed Care, one study reports:
For one third of newly prescribed medications, physicians discussed an aspect of acquisition, including cost and insurance coverage for 12%, logistics of obtaining medications for 18%, and medication supply for 9%. Patients initiated cost or insurance concerns for fewer than 2% of the new medications prescribed.
This low number of patients that ask about cost is alarming.
The FTC encourages patients to ask doctors about generic drugs.
Talk with your doctor or pharmacist. Explain that you want the most effective drug at the best price. Ask your doctor to write prescriptions for generic drugs when possible.
The FDA encourages patients and doctors to discuss the generic option.
[P]hysicians and their patients should discuss and decide whether a brand-name or generic is the best therapy.
Consumer groups have called for the use of generic drugs over brand name drugs.
Lipitor is among the most widely prescribed drugs to lower cholesterol, but Consumer Reports says doctors should consider its price before writing a prescription.
The consumer group says generic statins are as effective as high-priced brands for most people who need a statin drug, and can help consumers save more than $1,000 a year.
Yet, many doctors still prescribe expensive brand name drugs although cheaper options are available.
Why?
The March 28, 2007 issue of Nature Medicine says aggressive drug marketing may be to blame.
Critics say the sales reps' spiels hype new drugs when older, cheaper medications would suffice. And a growing number of studies have shown that even small gifts can create a sense of obligation, conscious or not, in the receiver. "Very small actions, even a gift worth a dollar or less, can affect prescribing behavior, and not necessarily in a way that's consistent with best practices," says says Margaret K. Cho, associate director of Stanford University's Center for Biomedical Ethics.
The Independent Drug Information Service is trying to circumvent the influence of aggressive drug marketing by providing "an accurate, up-to-date synthesis of relevant drug information in a non-biased format."
Their website explains how it works:
A team of physicians and drug researchers at Harvard Medical School comprehensively evaluate medical journals and other data sources to pull together the best available information about drugs used commonly in primary care practice. They then synthesize it into concise, clinically relevant summaries. These materials are presented to practitioners in their offices by a team of specially trained Independent Drug Information Service pharmacists, nurses, and other healthcare professionals.
Once doctors receive unbiased information regarding drugs the issue of cost needs to be discussed with the patient. One study reported that nearly 40% of seniors did not discuss cost related nonadherence with their doctors.
First, 27% of seniors who skipped doses or stopped taking a medicine because of side effects or poor perceived efficacy did not tell their physician. Second, 39% of seniors who reported cost-related nonadherence had not talked with their physicians about it. Third, physician–patient dialogue about medication costs was associated with patients’ being switched to lower cost medications.