NCPA - National Center for Policy Analysis


November 19, 2004

Doctors need to know how their patients bear the cost of medical treatment in order to reach positive health outcomes, says Rebecca Voelker, writing in the Journal of the American Medical Association.

Currently, doctors know very little about their patients' ability to pay for the medications they are being prescribed. One study finds that about 65 percent of physicians never discussed out-of-pocket costs with their patients.

Serious health consequences can result because patients will cut back on their medication either by skipping does or splitting pills if they don't have enough money. Voelker observes patients rarely discuss financial matters with their physician:

  • About two-thirds of individuals who cut back on their medication due to its expense never tell their physician in advance.
  • About one-third of individuals who cut back on their medication never even discuss medication cost with their physician; in two-thirds of these cases, their doctors never bothered to ask about their ability to pay.

Contributing to the problem is that most doctors do not know the cost of common prescription drugs, with many of them underestimating the financial burden.

As a result, the effective treatment of illnesses may be undermined due to doctors misinterpreting therapeutic failure for reasons other than the patient cutting back on their medication.

Source: Rebecca Voelker, "When Cost Is an Adverse Drug Effect, Patients Cut Corners and Risk Health," Journal of the American Medical Association, Vol. 292, No. 18, November 10, 2004.

For JAMA text (subscription required)


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