Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey

William H. Shrank, Henry N. Young, Susan L. Ettner, Peter Glassman, Steven M. Asch, Richard L Kravitz

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward "preferred" formulary medications. Objectives: To evaluate physicians' knowledge of formularies and out-of-pocket costs in such systems, as well as their perceived responsibility for helping patients manage out-of-pocket costs. Study Design: Self-administered written survey. Methods: Physician leaders participating in the California Medical Association Leadership Conference were surveyed. Results: A total of 133 responses were received from 205 participants (65% response rate). Physicians reported that they were often unaware of patients' out-of-pocket costs at the time of prescribing. Fifty-nine percent of physicians reported that they never or seldom were aware of patients' "preferred" (lower cost) formulary options when prescribing, and 70% never or seldom were aware of patients' out-of-pocket costs when prescribing. Although 88% of physicians agreed that it is important that patients' out-of-pocket costs for prescription drugs are managed, only 25% strongly or somewhat agreed that it is their "responsibilitz" to help. Instead, 69% of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. Physicians reported that they receive phone calls from pharmacists concerning formulary issues after 18.6% of the prescriptions they write. Conclusions: Physician leaders reported that they often do not possess the knowledge to assist patients in managing out-of-pocket costs for prescription drugs and they depend on pharmacists to communicate patient preferences in making prescribing decisions. As a result, price preferences are communicated indirectly, likely less efficiently, rather than intentionally when prescribing decisions are made.

Original languageEnglish (US)
Pages (from-to)16-22
Number of pages7
JournalAmerican Journal of Managed Care
Volume11
Issue number1
StatePublished - Jan 2005

Fingerprint

pharmaceutical
Health Expenditures
Motivation
incentive
physician
leadership
Physicians
Formularies
costs
Pharmaceutical Preparations
pharmacist
medication
Pharmacists
Prescription Drugs
leader
drug
medical association
responsibility
Surveys and Questionnaires
Patient Preference

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)

Cite this

Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey. / Shrank, William H.; Young, Henry N.; Ettner, Susan L.; Glassman, Peter; Asch, Steven M.; Kravitz, Richard L.

In: American Journal of Managed Care, Vol. 11, No. 1, 01.2005, p. 16-22.

Research output: Contribution to journalArticle

Shrank, William H. ; Young, Henry N. ; Ettner, Susan L. ; Glassman, Peter ; Asch, Steven M. ; Kravitz, Richard L. / Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey. In: American Journal of Managed Care. 2005 ; Vol. 11, No. 1. pp. 16-22.
@article{6da60e6bc32449bf87493ffe078c5036,
title = "Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey",
abstract = "Background: Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward {"}preferred{"} formulary medications. Objectives: To evaluate physicians' knowledge of formularies and out-of-pocket costs in such systems, as well as their perceived responsibility for helping patients manage out-of-pocket costs. Study Design: Self-administered written survey. Methods: Physician leaders participating in the California Medical Association Leadership Conference were surveyed. Results: A total of 133 responses were received from 205 participants (65{\%} response rate). Physicians reported that they were often unaware of patients' out-of-pocket costs at the time of prescribing. Fifty-nine percent of physicians reported that they never or seldom were aware of patients' {"}preferred{"} (lower cost) formulary options when prescribing, and 70{\%} never or seldom were aware of patients' out-of-pocket costs when prescribing. Although 88{\%} of physicians agreed that it is important that patients' out-of-pocket costs for prescription drugs are managed, only 25{\%} strongly or somewhat agreed that it is their {"}responsibilitz{"} to help. Instead, 69{\%} of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. Physicians reported that they receive phone calls from pharmacists concerning formulary issues after 18.6{\%} of the prescriptions they write. Conclusions: Physician leaders reported that they often do not possess the knowledge to assist patients in managing out-of-pocket costs for prescription drugs and they depend on pharmacists to communicate patient preferences in making prescribing decisions. As a result, price preferences are communicated indirectly, likely less efficiently, rather than intentionally when prescribing decisions are made.",
author = "Shrank, {William H.} and Young, {Henry N.} and Ettner, {Susan L.} and Peter Glassman and Asch, {Steven M.} and Kravitz, {Richard L}",
year = "2005",
month = "1",
language = "English (US)",
volume = "11",
pages = "16--22",
journal = "American Journal of Managed Care",
issn = "1088-0224",
publisher = "Ascend Media",
number = "1",

}

TY - JOUR

T1 - Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership survey

AU - Shrank, William H.

AU - Young, Henry N.

AU - Ettner, Susan L.

AU - Glassman, Peter

AU - Asch, Steven M.

AU - Kravitz, Richard L

PY - 2005/1

Y1 - 2005/1

N2 - Background: Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward "preferred" formulary medications. Objectives: To evaluate physicians' knowledge of formularies and out-of-pocket costs in such systems, as well as their perceived responsibility for helping patients manage out-of-pocket costs. Study Design: Self-administered written survey. Methods: Physician leaders participating in the California Medical Association Leadership Conference were surveyed. Results: A total of 133 responses were received from 205 participants (65% response rate). Physicians reported that they were often unaware of patients' out-of-pocket costs at the time of prescribing. Fifty-nine percent of physicians reported that they never or seldom were aware of patients' "preferred" (lower cost) formulary options when prescribing, and 70% never or seldom were aware of patients' out-of-pocket costs when prescribing. Although 88% of physicians agreed that it is important that patients' out-of-pocket costs for prescription drugs are managed, only 25% strongly or somewhat agreed that it is their "responsibilitz" to help. Instead, 69% of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. Physicians reported that they receive phone calls from pharmacists concerning formulary issues after 18.6% of the prescriptions they write. Conclusions: Physician leaders reported that they often do not possess the knowledge to assist patients in managing out-of-pocket costs for prescription drugs and they depend on pharmacists to communicate patient preferences in making prescribing decisions. As a result, price preferences are communicated indirectly, likely less efficiently, rather than intentionally when prescribing decisions are made.

AB - Background: Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward "preferred" formulary medications. Objectives: To evaluate physicians' knowledge of formularies and out-of-pocket costs in such systems, as well as their perceived responsibility for helping patients manage out-of-pocket costs. Study Design: Self-administered written survey. Methods: Physician leaders participating in the California Medical Association Leadership Conference were surveyed. Results: A total of 133 responses were received from 205 participants (65% response rate). Physicians reported that they were often unaware of patients' out-of-pocket costs at the time of prescribing. Fifty-nine percent of physicians reported that they never or seldom were aware of patients' "preferred" (lower cost) formulary options when prescribing, and 70% never or seldom were aware of patients' out-of-pocket costs when prescribing. Although 88% of physicians agreed that it is important that patients' out-of-pocket costs for prescription drugs are managed, only 25% strongly or somewhat agreed that it is their "responsibilitz" to help. Instead, 69% of physicians believed that it is the responsibility of the pharmacist to be familiar with patients' out-of-pocket costs. Physicians reported that they receive phone calls from pharmacists concerning formulary issues after 18.6% of the prescriptions they write. Conclusions: Physician leaders reported that they often do not possess the knowledge to assist patients in managing out-of-pocket costs for prescription drugs and they depend on pharmacists to communicate patient preferences in making prescribing decisions. As a result, price preferences are communicated indirectly, likely less efficiently, rather than intentionally when prescribing decisions are made.

UR - http://www.scopus.com/inward/record.url?scp=12144285234&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12144285234&partnerID=8YFLogxK

M3 - Article

VL - 11

SP - 16

EP - 22

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

IS - 1

ER -