“It seems that everyone’s talking about the high costs of drugs—to friends, with family, on social media—but where those conversations are not happening often enough is at the doctor’s office.” So begins this important article that appeared in the pages of Consumer Reports. Although the article was written a while back, it reflects a situation that is extremely current – and problematic – today: doctors are not doing enough to educate their patients about the costs of the drugs they prescribe.
In 2016 Consumer Reports conducted a telephone survey of more than 2,000 adults who were taking prescribed medications. The shocking finding from the survey was that only about 6 percent of patients found out the cost of a new medication during their visit with the prescribing doctor. By contrast, almost two-thirds of respondents said “they didn’t learn the price of the drug until they were standing at the pharmacy counter,” in the words of the magazine article, adding, “considering that doctors prescribed an estimated 4.4 billion drugs last year, not talking about a patient’s ability to pay can be an expensive oversight.”
The irony, says the Consumer Reports feature, is that most doctors (about 80 percent) say they are concerned about their patients’ ability to afford prescription drugs in this era of skyrocketing costs – yet these same physicians only discuss drug costs with about one-quarter of their patients. In fact, says the article, in a large majority of the cases in which patients talked about drug prices with their physicians, it was the patient, and not the doctor, who initiated the conversation. It would seem that doctors are going out of their way to avoid talking dollars and cents when prescribing drugs to patients who might not be able to afford what the doctor is prescribing.
Consumer Reports explains why this reluctance to talk about drug costs might exist in the mind of health care professionals. “While doctors say they are concerned about affordability, when it comes to treatment decisions, they were more likely to consider efficacy and safety than affordability.” This suggests that doctors are reluctant to have the “cost conversation” with their patients. “When asked to name the leading reason restricting their conversations about costs with patients,” says Consumer Reports, “at least half of doctors said that they can’t easily access cost information for each patient and don’t have time to find it.”
According to the American Medical Association’s own website (in an article we found here), the medical community may finally be sounding the alarm on high drug costs. “Brand name drug prices in the U.S. have spiked 98.2 percent since 2011,” said the AMA late last year, adding that the average price of brand-name drugs rose more than 16 percent in 2015 alone. The AMA also says that the high cost of drugs relates directly to higher health insurance premiums. “Prescription drug prices have been frequently cited as a main justification for higher health insurance premiums,” the AMA writes. “For patients with commercial health insurance, out-of-pocket costs for brand prescriptions have increased by more than 25 percent since 2010.” Surveys from established health care think tanks report that many Americans say dealing with the high cost of prescription drugs should be one of the nation’s top health care priorities.
According to Consumer Reports, physicians’ groups seem to be waking up to the need to encourage their members to talk about drug costs with their patients. The American College of Physicians, the second largest physicians group in the country, published a position paper challenging the medical community for their silence on the subject. According to ACP President Wayne Riley, M.D. “Patients and their families are clearly struggling with the costs of even routine medications.” He adds that the pharmaceutical industry “must be more responsive to this problem or there will be stronger pleas from many for mandated transparency, price controls, and more regulation.” In other words, if private medical practitioners and drug manufacturers don’t open up about the cost of prescription drugs, the government may step in and insist on it. Doctors may be getting the message: Consumer Reports says that two-thirds of physicians in the magazine’s survey say they are either very likely or somewhat likely to be more intentional about discussing drug affordability with patients in the next 12 months. But only time and patient experience will tell.
Here at AgingOptions, our advice to patients – especially seniors – is that you have to start thinking and acting like a consumer when it comes to your health care. It has been widely known for years that older patients have a greater tendency than younger ones to take doctors at their word and never ask challenging questions. We say the time for that kind of acquiescence is long past. These days with costs skyrocketing and doctors spending less and less time with their patients, you may have to demand answers from your medical practitioners, not in an argumentative way but in a very direct manner; and if those answers aren’t forthcoming it might be time to switch doctors. If you are a senior we highly recommend hiring a geriatrician as your primary health care provider, since only these geriatric physicians are properly trained to deal with the unique health care needs of older patients. Most geriatricians we know about will take the time to explain their recommendations to you, and they’ll often be more inclined to take you off of certain prescriptions than to keep adding more pills to your medical regimen. Contact us here at AgingOptions and we will refer you to a geriatrician in your area.
Planning adequately for retirement means much more than making sure you have the right health insurance. Too many people focus their attention on one single aspect of retirement – health care, or finances, or housing – and miss the bigger picture. Every facet of your retirement is important, and it’s essential that your finances, legal protection, housing choices, medical coverage and family communication all work together seamlessly. There’s one comprehensive approach to retirement planning that accomplishes this strategic integration, and that’s an AgingOptions LifePlan. We invite you to come spend a few hours with us and find out more, at a free LifePlanning Seminar with Rajiv Nagaich. These popular events take place at locations throughout the Puget Sound area, and there’s likely to be one coming up that’s convenient for you. For details and online registration, click here – or call us for assistance by phone during the week.
Retirement planning doesn’t have to be tedious, complex and disjointed. Discover the power of comprehensive retirement planning with a LifePlan from AgingOptions.
(originally reported at www.consumerreports.org)