Patients, Doctors Don't Discuss Rx Prices
Poll Shows Cost of Drugs Isn't a Factor in Doctor-Patient Discussions
March 17, 2009 -- Most patients never talk about price when getting a drug
prescription from their doctor, and few confront the actual price of their
drugs before it's time to pay at the pharmacy, according to a poll released by
The group is urging doctors and patients to factor in the price of drugs
when deciding on treatments. They're pointing to generics, which in many cases
are just as effective and safe for the fraction of the price of a brand-name
"If cost is an issue, have a heart-to-heart with your doctor and make
sure he or she knows that costs are an issue," says John Santa, MD, an
internist and director of the Consumer Reports health rating center.
Consumers Union released a poll of roughly 2,000 adults showing that just 4%
discussed price when getting a drug prescription from their doctor; as many as
60% of those polled learned about the price of their drugs for the first time
at the pharmacy register.
The poll was conducted between Jan. 15 and Jan. 19; it has a margin of error
of plus or minus 3.4 percentage points.
The poll confirms what many other studies have shown: that many patients
regularly resort to measures such as cutting pills in half, skipping doses, or
skipping medication altogether in an effort to save on medical bills.
"Sticker shock is really taking a toll on American consumers," says
Ed Farrell, director of national research at Consumer Reports.
The magazine's latest issue has a guide to cheaper generics in about 20 drug
classes, including drugs for high blood pressure, depression, and high
Comparative Effectiveness Research
Consumers Union is backing an Obama administration plan to boost research
directly comparing the effectiveness of different drugs, devices, and other
treatments. The hope is to find less-expensive treatments or tests that work as
well as the more expensive versions.
Congress spent $1.1 billion in the economic stimulus bill to jump-start
so-called "comparative effectiveness" research at the federal
But comparative effectiveness research -- or at least the way the government
and insurers might use it -- is controversial.
Drugmakers, device manufacturers, and other industry groups worry that it
could be used as an excuse to ration health care. They warn that the government
and insurers could decide to pay only for the cheapest treatments, impairing
the decisions doctors and patients can make.
Robert Moffitt, director of the Center for Health Policy Studies at the
Heritage Foundation, says few are opposed to getting the best treatments for
the best price. "Who the heck is against that?" he says.
"The issue is a federal infrastructure that will give a seal of approval
about what to do," he says. He urges doctors and patients to have "a
profound distrust" of how the research could be used as Washington tries to
find a way to save hundreds of billions of dollars as part of overall health
Sen. Tom Coburn, R-Okla., was also critical of the proposal. "They're
going to look at cost, just like England does, and say, we can't afford it so
we won't do it," he says. Coburn is a doctor and a member of the Senate
Committee on Health, Education, Labor, and Pensions.
Policy makers have not yet decided how health programs like Medicare will
use head-to-head research for drugs and treatments, or how the data will fit
into overall health reform.
"The government has a real opportunity to provide neutral, credible,
transparent public information for everybody to see," Santa says.