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While physicians are well aware of the general issue of high drug costs, they don’t often know the actual costs of drugs they prescribe to their patients. That’s a key finding of a recent survey of 189 physicians at Mount Sinai Medical Center in New York City.1
To help with cost awareness, practice officials at Mount Sinai are posting actual costs of 100 commonly prescribed drugs on the medical center’s intranet, say Steven Reichert, MD, Todd Simon, MD, and Ethan Halm, MD, all on staff at Sinai, and researchers for the survey project.
Sinai leadership is hoping this simple information resource is one way to make at least a dent in physician awareness of what patients are paying for specific drugs so that both patients and institutional costs can be better monitored. The Web site is available from any physician work station.
Drug cost reporting is just one outcome of the study aimed at measuring attitudes about prescribing and knowledge of medication costs among both attending physicians and residents. In the study of physician knowledge and attitudes, researchers found the overwhelming majority (82%) of physicians feel that cost of medicines is an important consideration in prescribing, and 71% were willing to sacrifice some efficacy to make drugs more affordable.
While physicians have access to hospital- and office-based drug costs, they often lack knowledge of what patients pay for drugs in retail settings. Only 33% had easy access to what drugs cost consumers.
"Two factors likely contribute to continued inadequate knowledge of medication costs," Reichert and colleagues report. "First, medical schools and residency training programs provide little or no formal education about medication costs and insurance coverage of pharmaceuticals. Second, there are few ways to obtain reliable drug price information in a timely fashion. Cost information is rarely if ever included in medical journals, textbooks, or drug-prescribing guides [including the Physicians Desk Reference]."
The variation in practice- and hospital-based drug purchases is widely reported. (See Physician’s Managed Care, October 1999, July 1999, and March 1998.) Drug companies sometimes offer discounts and rebates to providers in conjunction with certain managed care companies, and even finding agreement on average wholesale prices offered to larger groups is not easy. What individual patients or customers pay may not resemble what providers or insurers have access to.
A little bit of accurate information may go a long way, Reichert and team say, given the survey’s finding that physicians are open to learning about true drug costs for patients. "Physicians were predisposed to being cost-conscious in their prescribing habits, but lacked accurate knowledge about actual costs and insurance coverage of drugs," the study says. "Interventions are needed to educate physicians about drug costs and provide them with reliable, easily accessible cost information in real-world practice."
1. Reichert S, Simon T, Halm E. Physicians’ attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med 2000; 160:2799-2803.