Doctors Mum on Prescription Prices

Imagine going out to eat at a nice restaurant, getting an impressive menu, but not finding prices for anything. Most people would find such a situation disorienting. They would hesitate to order a meal at a restaurant that won’t tell its patrons beforehand what the food will cost.
When it comes to drugs, however, most people have no idea what they will cost until they get the bill. Millions of Americans routinely visit a doctor’s office and rarely ask what their medications will cost until they are standing in the pharmacy.
A recent study published in the American Journal of Managed Care (Nov. 2006) revealed that physicians and patients rarely talk about how much prescription medicines will cost. The researchers tape-recorded office visits.
When prescribing a new drug, doctors discussed the subject of medication costs and insurance only one time out of eight. Patients were even less likely to bring up the subject. They asked about price less than 2 percent of the time. It was a classic case of don’t ask, don’t tell.
The trouble is that when patients get to the pharmacy and discover how much their medicine will cost, they often experience sticker shock. Some just turn around and walk out the door without even filling the prescription. Others ask the pharmacist to come to their rescue.
Pharmacists spend hours on the telephone with doctors’ offices negotiating about drugs not covered by the patient’s insurance. Since physicians may not realize how expensive their prescriptions can be, the pharmacist is frequently the one who breaks the bad news.
The consequence is what doctors refer to as “noncompliance.” This means patients don’t take their medicine. Although noncompliance implies a patient who is being uncooperative, often it’s a matter of financial survival.
One reader shared her situation: “I am 79, single and have no pension after 40 years of work as a paralegal in Washington DC law firms. I get less than $900 Social Security per month plus a small dividend income. I was never married so do not benefit from a dead husband’s insurance. I suffer from asthma, GERD, pancreatitis and am a cancer survivor. I cannot afford all the drugs that are prescribed for me, so I do without all but the two most essential.”
This person is not unique. Researchers have found that 25 percent of older people skip medicines for high blood pressure, high cholesterol, asthma or emphysema because of cost. The consequences are more frequent emergency room visits and serious health complications.
It is time both patients and physicians stop pretending that money doesn’t matter. Discussions of prescription drug costs are essential before the patient leaves a doctor’s office.
To help facilitate this difficult conversation, we have prepared a Guide to Saving Money on Medicine. It covers tips for cutting costs and tells consumers how to find reputable Canadian pharmacies online. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (63 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. CA-99, P. O. Box 52027, Durham, NC 27717-2027. It can also be downloaded for $2 from the Website: www.peoplespharmacy.com.