The Cost of Medicine
This will be familiar to all of you who maintain a clinical practice.
It was ten years ago. I get a phone call from a friend who asks me if I will see a friend of his who is visiting from Indiana and has developed a bad cough. So I agree. The cough turns out to be pneumonia. The pneumonia is not bad enough to require a hospitalization, but it’s definitely something that needs an antibiotic.
So I prescribe a well-known antibiotic—a super drug that requires only a five-day course and once-a-day dosing.
A few hours later the friend-of-a-friend calls me from the pharmacy. “I can’t get the medicine you prescribed,” he says, “because they want $140.00. A hundred and forty dollars for six pills!” To be honest, I had no idea. For nearly twenty years I have been practicing in a prepaid health plan in which most patients pay somewhere between a dollar and $15 for any prescription. I was leading a sheltered life!
For the friend of a friend, I wrote a new prescription: a ten-day course of generic doxycycline that cost him less than $20.00. It worked. A few weeks later I got thank-you email.
It turns out I’m not the only doc who has been shielded from the cost of prescription drugs. A recent study published in the Journal of Managed Care revealed that only about a third of the time did physicians discuss cost issues with their patients. Conversely, patients initiated discussion of cost issues only two-percent of the time.
I hasten to add that since my experience with the expensive antibiotic, I always ask about cost issues when I prescribe a new medication. Some of these costs are statospheric. The newer disease modifying agents for rheumatoid arthritis, for example, can run more than $1000 per month.
And speaking of drug costs, my next posting concerns the upcoming Medicare Part D enrollment period. Check it out.
Technorati Tags: prescription drugs, health care costs, generic drugs
Home