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Patients don't tell docs when they stop taking meds due to money woes

Quality Improvement Monitor, September 17, 2004

Clinicians should be more proactive when it comes to identifying and helping patients who have problems paying for expensive prescription drugs. That's the conclusion of researchers who found that two-thirds of chronically ill patients don't inform their physicians when they decide to cut back on their medications for financial reasons.

What's worse; physicians don't ask patients whether the cost of their medication will affect their ability to take it, according to new research in the September 13 Archives of Internal Medicine (Vol. 164 No. 16).

John Piette, PhD, and colleagues from the Center for Practice Management and Outcomes Research at the VA Ann Arbor (MI) Health Care System, surveyed 4,055 adults age 50 or older who were taking prescription drugs for high cholesterol, diabetes, heart problems, or depression.

Of these, 660 (16%) told researchers they had delayed or stopped taking some of their medication in the previous year due to their cost. In addition, about two-thirds of this group said they didn't inform their physician ahead of time, 35% said they had never discussed drug costs with their physician, and 58% didn't think their provider could help them.

And although 72% of patients who did talk with their clinicians about drug costs found those conversations helpful, 31% reported that their medications were never changed to a generic or less expensive alternative, and few patients (30%) received information about programs that help pay for drug costs.

Patients were more likely to find a clinician helpful if the clinician provided free samples, asked whether the patient had any problems paying for prescriptions, and offered advice on how to pay for the drugs.

"Many patients appreciated a simple inquiry from their clinician about whether they could afford a specific prescription," the researchers conclude. "As drug costs continue to escalate and the number of adults with chronic illnesses grows, it will be increasingly important for health care providers to take an active role in discussing patients' medication cost problems and appropriate strategies for addressing them."

-- Wendy Johnson
wjohnson@hcpro.com

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