Physicians' attitudes about prescribing and knowledge of the costs of common medications

Background: Compliance with medical therapy is often compromised because pa tients cannot afford to pay for medications. Inadequate physician knowledge of drug costs may unwittingly contribute to this problem. Objective; To measure attitudes about prescribing and knowledge of medicati on costs and compare differences among attending physicians and residents. Design/Participants: Written survey of internal medicine house staff and ge neral medicine attending physicians in an urban hospital-based primary care center. Results: One hundred thirty-four of 189 physicians responded (71% response rate). Seventy percent of respondents were house officers and 30% were atte nding physicians. Eighty-eight percent of physicians felt the cost of medic ines was an important consideration in the prescribing decision, and 71% we re willing to sacrifice some degree of efficacy to make drugs more affordab le for their patients. However, 80% often felt unaware of the actual costs. Only 33% had easy access to drug cost data, and only 13% had been formally educated about drug costs. Regarding insurance coverage, 94% of physicians gave strong consideration to the cost of medications when patients were se lf-paying, 68% when patients had Medicare, and 30% when patients had Medica id or were participants in a health maintenance organization with a prescri ption plan. Physicians' estimates of the cost of a month's supply of 33 com monly used medications were accurate in 45% of cases, too low for 40%, and too high for 15%. The costs of brand-name and expensive drugs were most lik ely to he underestimated. House officers were less cost-conscious than atte nding physicians. Conclusions: Physicians were predisposed to being cost-conscious in their p rescribing habits, but lacked accurate knowledge about actual costs and ins urance coverage of drugs. Interventions are needed to educate physicians ab out drug costs and provide them with reliable, easily accessible cost infor mation in real-world practice.