Doctors need to discuss drug costs with patients

Doctors may not like talking to patients about money, but when it comes to drug costs it’s a discussion physicians should be ready to have, writes cardiologist Payal Kohi, M.D.

With all of the new medications available, doctors need to know about the costs of new drugs and factor that into conversations with patients and into decisions about which drug to choose, says Kohi, an attending cardiologist for Kaiser Permanente in Denver, Colorado, in a Medical Economics blog post.

“I implore you to learn about costs for your most-frequently prescribed drugs, not just for the patient’s benefit and to maximize your patient outcomes, but because knowledge of a drug’s cost is quickly becoming just as important as the drug’s efficacy or safety,” she writes, adding that she usually saves the discussion until the end of an office visit because patients tend to tune out other information once they start thinking about money.

A doctor, for instance, can offer a patient who needs oral anticoagulation therapy for stroke prevention one of five different drugs.

She compares choosing a medication to the kind of car a patient would buy. Would they choose a Toyota, a Tesla, a BMW or a Porsche, she asks, to gain insight into their approach to costs versus benefits. The Toyota driver, for instance, may want a car that can get them to where they need to go with good gas mileage, but be willing to get more frequent repairs. They may opt for a generic low-cost drug and not mind the need for frequent blood tests. The Tesla driver may be willing to pay for a more expensive drug that does not require those checks. And then there are some drugs that so expensive (she sites Repatha which costs $14,100 for a year’s supply) that may never be affordable for the average patient, similar to a luxury car like a BMW.

Prescription drug costs are the big driver of healthcare costs and can dictate whether patients will adhere to the therapy, she says.

A survey earlier this year found more than 25 percent of patients reportedly failed to comply with recommended tests or treatments due to cost, and patients cited the high cost of prescription drugs more frequently than any other factor as the reason for rising healthcare expenses. Prescribing generic drugs lowers the cost and increases patient adherence, as FiercePracticeManagement reported.

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