Cost awareness has limited effect on prescribing

With prescription costs rising, many physicians are being asked to talk more with patients about their insurance coverage and prescribe generics where appropriate.

By Mike Norbut, AMNews staff. March 3, 2003.

Many physicians don't know the cost of common prescription drugs, and education efforts about insurance coverage and low-cost alternatives only slightly improved their awareness level and prescribing habits, according to a recent study.

Authors of the study, which was published in the January issue of the Journal of General Internal Medicine, said they were "humbled" by the limited effects their efforts had on the participating doctors, including attending physicians and residents at four hospitals in New York City and northern New Jersey.

Physicians were initially surveyed about their knowledge of prescription drugs. Then they were given a pocket-sized reference booklet listing medication costs and invited to attend a 45-minute presentation about insurance coverage and the prices many patients have to pay.

About a year after the initial survey, physicians were questioned again; according to the study, their knowledge of the drugs increased 33%, but the likelihood they would ask patients about their out-of-pocket costs and their overall awareness of costs saw only slight improvements.

"The good news is, with low-intensity intervention, we were able to improve their cost consciousness," said the study's lead author, Ethan Halm, MD, MPH, an internist and assistant professor of medicine and health policy at the Mount Sinai School of Medicine in New York City. "The not-so-good news is, we were only able to move it so much."

Responses to the study among physicians were mixed. While some said they are constantly inundated with questions about drug costs, others said it's not always easy for doctors to discern the scope of each patient's insurance coverage.