“Though cost discussions are not always necessary, especially if physicians know a patient's financial situation and the best formulary choice for a medication, physicians must have a high level of awareness about medication cost and issues impeding acquisition to medication, because these can be important barriers to patient medication adherence,” said Dr. Derjung Tarn, assistant professor of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.
The researchers used a combination of patient and physician surveys and transcriptions from audio-taped patient visits. They included a total of 185 patients on outpatient visits with 15 family physicians, 18 internists and 11 cardiologists. Some 243 new medications were prescribed during these sessions.
The researchers found that in only 33 percent of the cases did physicians prescribing new medications communicate about issues related to medication acquisition such as cost, insurance, generic or brand name, logistics, supply and refills. Costs and insurance were covered 12 percent of the time, the logistics of obtaining medications 18 percent of the time, and medication supply nine percent of the time. Patients initiated discussions about costs or insurance in only two percent of the cases.
Discussions about costs were likelier to take place when the patient earned less than $20,000 per year compared with patients whose annual income topped $60,000, the researchers found. Also, family physicians and internists were less likely than cardiologists to discuss costs, and physicians in general brought up the issue less when prescribing medications to older patients.
MEDICA.de; Source: University of California, Los Angeles