What do physicians know about cost of medications? Do they have the time to talk out-of-pocket costs with patients? Will e-prescribing technology help them?
When prescribers do talk costs, the conversation lasts on average nine seconds (Tarn et al, 2008). If you count the additional seconds to look up the formulary of a patient and determine the co-pay for the medication being considered, there are tens of seconds involved.
The evidence to date is pretty clear that physicians don't know much about the cost of medications nor have the time to talk costs with patients. What is not known is the formulary check capabilities of e-prescribing helping them. Given that the majority of e-prescribing seems to be done by surrogate prescribers, what is the likelihood? I'll keep this page updated when studies become available.
References
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.
Graber, MA, Randles, BD, Monahan, J, Ely, JW, Jennissen, C, Peters, B & Anderson, D 2007, 'What Questions About Patient Care Do Physicians Have During and after Patient Contact in the Ed? The Taxonomy of Gaps in Physician Knowledge', Emergency Medicine Journal, Vol. 24, no. 10, pp. 703-6.
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.
Patel, MR, Coffman, JM, Tseng, C-W, Clark, NM & Cabana, MD 2009, 'Physician Communication Regarding Cost When Prescribing Asthma Medication to Children', Clinical Pediatrics, Vol. 48, no. 5, pp. 493-8.
Schmittdiel, J, Steers, N, Duru, OK, Ettner, S, Brown, A, Fung, V, Hsu, J, Quiter, E, Tseng, C-W & Mangione, C 2010, 'Patient-Provider Communication Regarding Drug Costs in Medicare Part D Beneficiaries with Diabetes: A Triad Study', BMC Health Services Research, Vol. 10, no. 1, p. 164.
Shrank, WH, Asch, SM, Joseph, GJ, Young, HN, Ettner, SL, Kholodenko, Y, Glassman, P & Kravitz, RL 2006, 'Physicians' Perceived Knowledge of and Responsibility for Managing Patients' out-of-Pocket Costs for Prescription Drugs', Annals of Pharmacotherapy, Vol. 40, no. 9, pp. 1534-40.
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.
Shrank, WH, Choudhry, NK, Fischer, MA, Avorn, J, Powell, M, Schneeweiss, S, Liberman, JN, Dollear, T, Brennan, TA & Brookhart, MA 2010, 'The Epidemiology of Prescriptions Abandoned at the Pharmacy', Annals of Internal Medicine, Vol. 153, no. 10, pp. 633-40.
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.
Wilbur, K 2009, 'Resident Physician and Hospital Pharmacist Familiarity with Patient Discharge Medication Costs', Pharmacy World & Science, Vol. 31, no. 2, pp. 195-201.