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Improving physicians’ knowledge of the costs of common medications and willingness to consider costs when prescribing

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Abstract

OBJECTIVE: To determine the effectiveness of an educational intervention designed to improve physicians’ knowledge of drug costs and foster willingness to consider costs when prescribing.

DESIGN: Pre- and post-intervention evaluation, using physicians as their own controls.

SETTING: Four teaching hospitals, affiliated with 2 residency programs, in New York City and northern New Jersey.

PARTICIPANTS: One hundred forty-six internal medicine house officers and attendings evaluated the intervention (71% response rate). Of these, 109 had also participated in a pre-intervention survey.

INTERVENTION: An interactive teaching conference and distribution of a pocket guide, which listed the average wholesale prices of over 100 medications commonly used in primary care

MEASUREMENTS AND MAIN RESULTS: We administered a written survey, before and 6 months after the intervention. Changes in attitudes and knowledge were assessed, using physicians as their own controls, with Wilcoxon matched-pairs signed-rank tests. Eighty-five percent of respondents reported receiving the pocket guide and 46% reported attending 1 of the teaching conferences. Of those who received the pocket guide, nearly two thirds (62%) reported using it once a month or more, and more than half (54%) rated it as moderately or very useful. Compared to their baseline responses, physicians after the intervention were more likely to ask patients about their out-of-pocket drug costs (22% before vs 27% after; P<.01) and less likely to feel unaware of drug costs (78% before vs 72% after; P=.02). After the intervention, physicians also reported more concern about the cost of drugs when prescribing for patients with Medicare (58% before vs 72% after; P<.01) or no insurance (90% before vs 98% after; P<.01). Knowledge of the costs of 33 drugs was more accurate after the intervention than before (P<.05).

CONCLUSION: Our brief educational intervention led to modest improvements in physicians’ knowledge of medication costs and their willingness to consider costs when prescribing. Future research could incorporate more high-intensity strategies, such as outreach visits, and target specific prescribing behaviors.

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References

  1. Iglehart JK. Medicare and prescription drugs. N Engl J Med. 2001;344:1010–5.

    Article  PubMed  CAS  Google Scholar 

  2. Iglehart JK. The American health care system—Expenditures. N Engl J Med. 1999;340:70–6.

    Article  PubMed  CAS  Google Scholar 

  3. Pear R. Budget office’s estimates for drug spending grow: adding to challenge of Medicare coverage. New York Times. February 24, 2001:A7.

  4. Davis M, Poisal J, Chulis G, Zarabozo C, Cooper B. Prescription drug coverage, utilization, and spending among Medicare beneficiaries. Health Aff (Millwood). 1999;18:231–43.

    Article  CAS  Google Scholar 

  5. Mehl B, Santell J. Projecting future drug expenditures—2001. Am J Health Syst Pharm. 2001;58:125–33.

    PubMed  CAS  Google Scholar 

  6. Soumerai SB, Ross-Degnan D. Inadequate prescription-drug coverage for Medicare enrollees—A call to action. N Engl J Med. 1999;340:722–8.

    Article  PubMed  CAS  Google Scholar 

  7. Etheredge L. Purchasing Medicare prescription drug benefits: a new proposal. Health Aff (Millwood). 1999;18:7–19.

    Article  CAS  Google Scholar 

  8. Pear R. Spending on prescription drugs increases by almost 19 percent: doctors are using more of costliest medicines. New York Times. May 8, 2001:A1, A16.

  9. Reichert S, Simon T, Halm EA. Physicians’ attitudes about prescribing and knowledge of the costs of common medications. Arch Intern Med. 2000;160:2799–803.

    Article  PubMed  CAS  Google Scholar 

  10. Beringer GB, Biel M, Ziegler DK. Neurologists’ knowledge of medication costs. Neurology. 1984;34:121–2.

    PubMed  CAS  Google Scholar 

  11. Fowkes FG. Doctors’ knowledge of the costs of medical care. Med Educ. 1985;19:113–7.

    PubMed  CAS  Google Scholar 

  12. Glickman L, Bruce EA, Caro FG, Avorn J. Physicians’ knowledge of drug costs for the elderly. J Am Geriatr Soc. 1994;42:992–6.

    PubMed  CAS  Google Scholar 

  13. Hoffman J, Barefield FA, Ramamurthy S. A survey of physician knowledge of drug costs. J Pain Symptom Manage. 1995;10:432–5.

    Article  PubMed  CAS  Google Scholar 

  14. Miller LG, Blum A. Physician awareness of prescription drug costs: a missing element of drug advertising and promotion. J Fam Pract. 1993;36:33–6.

    PubMed  CAS  Google Scholar 

  15. Oppenheim GL, Erickson SH, Ashworth C. The family physician’s knowledge of the cost of prescribed drugs. J Fam Pract. 1981;12:1027–30.

    PubMed  CAS  Google Scholar 

  16. Rowe J, MacVicar S. Doctors’ knowledge of the cost of common medications. J Clin Hosp Pharm. 1986;11:365–8.

    PubMed  CAS  Google Scholar 

  17. Ryan M, Yule B, Bond C, Taylor RJ. Scottish general practitioners’ attitudes and knowledge in respect of prescribing costs. BMJ. 1990;300:1316–8.

    Article  PubMed  CAS  Google Scholar 

  18. Walzak D, Swindells S, Bhardwaj A. Primary care physicians and the cost of drugs: a study of prescribing practices based on recognition and information sources. J Clin Pharmacol. 1994;34:1159–63.

    PubMed  CAS  Google Scholar 

  19. Weber ML, Auger C, Cleroux R. Knowledge of medical students, pediatric residents, and pediatricians about the cost of some medications. Pediatr Pharmacol (New York). 1986;5:281–5.

    CAS  Google Scholar 

  20. Top 200 brand-name Rx drugs. In: Cardinale V, ed. 1998 Drug Topics Red Book. Montvale, NJ: Medical Economics Co.;1998:130.

    Google Scholar 

  21. Top 200 generic Rx drugs. In: Cardinale V, ed. 1998 Drug Topics Red Book. Montvale, NJ: Medical Economics Co.;1998:131.

    Google Scholar 

  22. Abramowicz M. ed. The Medical Letter: On Drugs and Therapeutics. New Rochelle, NY, Feb. 1995 – Aug. 1998.

  23. Cardinale V, ed. 1998 Drug Topics Red Book. Montvale, NJ: Medical Economics Co.;1998.

    Google Scholar 

  24. Rosner B. Fundamentals of Biostatistics, 5th ed. Pacific Grove, Calif: Duxbury; 2000.

    Google Scholar 

  25. Salman H, Bergmann M, Hart J, et al. The effect of drug cost on hypertension treatment decision. Public Health. 1999;113:243–6.

    Article  PubMed  CAS  Google Scholar 

  26. Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA. 1995;274:700–5.

    Article  PubMed  CAS  Google Scholar 

  27. Grimshaw JM, Shirran L, Thomas R, et al. Changing provider behavior: an overview of systematic reviews of interventions. Med Care. 2001;39:II2–45.

    Article  PubMed  CAS  Google Scholar 

  28. Grol R. Improving the quality of medical care: building bridges among professional pride, payer profit, and patient satisfaction. JAMA. 2001;286:2578–85.

    Article  PubMed  CAS  Google Scholar 

  29. Thomson O’Brien MA, Freemantle N, Oxman AD, Wolf F, Davis DA, et al. Continuing education meetings and workshops: effects on professional practice and health care outcomes (Cochrane Review). In: The Cochrane Library, Issue 2. Oxford: Update Software; 2002.

    Google Scholar 

  30. ePocrates Rx. version 4.0. Available at: http://epocrates.com. Accessed September 23, 2002.

  31. Pocket Pharmacopeia software. Available at: http://tarasonpublishing.com/store/palm.asp. Accessed September 23, 2002.

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Correspondence to Lisa M. Korn MD, MPH.

Additional information

Dr. Korn was a fellow in the Robert Wood Johnson Foundation Clinical Scholars Program at the time this project was completed. Dr. Halm is supported in part by the Robert Wood Johnson Foundation Generalist Physician Faculty Scholars Program. Funding for the educational intervention was provided by the Department of Medicine, Mount Sinai School of Medicine, New York, NY. The authors have no conflicts of interest to disclose.

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Korn, L.M., Reichert, S., Simon, T. et al. Improving physicians’ knowledge of the costs of common medications and willingness to consider costs when prescribing. J GEN INTERN MED 18, 31–37 (2003). https://doi.org/10.1046/j.1525-1497.2003.20115.x

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  • DOI: https://doi.org/10.1046/j.1525-1497.2003.20115.x

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