Post date: Dec 9, 2010 4:01:12 PM
An implicit assumption with e-prescribing is the prescriber being willing to take the time to make a formulary check. Even if the patient's formulary is available (chatter on internet suggests its not due to missing functionaility or incomplete data), the prescriber has to be willing to do something. Patients certainly want some feedback to combat rising prescription drug prices. Prescription abandonment has been a rising concern (see earlier post).
The Kaiser Family Foundation survey of 2006 reported half the doctors "frequently" talking with patients about out-of-pocket costs. This is a jump from the Alexander et al (2003) study reporting only 35% of physicians doing so (and patients saying only 15%). When they do talk costs the conversation averages nine seconds (Tarn et al, 2008).
Patient demographic seems to make a difference on the sensitivity of physicians to out of pocket costs. For every 10% increase in the number of privately insured patients, a physician was less likely to ask about cost (Patel et al, 2009)
Alexander, GC, Casalino, LP & Meltzer, DO 2003, 'Patient-Physician Communication About out-of-Pocket Costs', Journal of the American Medical Association, Vol. 290, no. 7, pp. 953-8.
2006, Prescription Drugs: Advertising, out-of-Pocket Costs, and Patient Safety from the Perspective of Doctors and Pharmacists, Kaiser Family Foundation.
Khan, S, Sylvester, R, Scott, D & Pitts, B 2008, 'Physicians’ Opinions About Responsibility for Patient out-of-Pocket Costs and Formulary Prescribing in Two Midwestern States', Journal of Managed Care Pharmacy, Vol. 14, no. 8, pp. 780-9.
Shrank, WH, Fox, SA, Kirk, A, Ettner, SL, Cantrell, CH, Glassman, P & Asch, SM 2006, 'The Effect of Pharmacy Benefit Design on Patient-Physician Communication About Costs', Journal of General Internal Medicine, Vol. 21, no. 4, pp. 334-9.
Tarn, DM, Paterniti, DA, Kravitz, RL, Heritage, J, Liu, H, Kim, S & Wenger, NS 2008, 'How Much Time Does It Take to Prescribe a New Medication?' Patient Education and Counseling, Vol. 72, no. 2, pp. 311-9.
See the page Talking Prescription (Rx) costs.