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 language | English (US) |
|---|---|
| Pages (from-to) | 16-22 |
| Number of pages | 7 |
| Journal | American Journal of Managed Care |
| Volume | 11 |
| Issue number | 1 |
| State | Published - Jan 2005 |
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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 journal › Article
}
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.
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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 -