Background Medication costs can lead to financial burdens for patients, creating barriers to effective medication use. Health care provider use of real‐time benefit tools (RTBTs) may facilitate cost conversations with patients. We sought to explicate patient views on how RTBTs could be used to improve cost considerations in prescribing decisions. Methods We conducted focus groups to characterize patient perspectives on holding cost conversations with their physicians and to identify factors that would influence the value of RTBTs. We focused on adults aged 50+ who reported trouble paying for their prescriptions. Three groups included patients with conditions requiring high‐cost treatments and one group included lower‐income patients independent of their medical conditions. Focus groups were recorded, transcribed, coded, and categorized to salient themes employing inductive and deductive approaches using the Health Equity Implementation Framework. Results Focus groups were conducted from 09/2020–12/2020 including 18 participants representing cancer (n = 6), diabetes (n = 6), rheumatoid arthritis (n = 3), and lower income (n = 3). Participants were between 50–74, eight self‐identified as Black, 10 as White, and eight reported earning <$50,000/year. We identified five themes regarding cost conversations (medication cost importance, past experiences with cost/cost conversations, perception of physician's role and knowledge, knowledge of existing resources, and influence on decision‐making) and four RTBT‐use‐specific themes (advantages/disadvantages, perceived relevance, data quality concerns, and implementation considerations). Conclusion Approaches that envision RTBTs as one‐size‐fits‐all technological interventions may underestimate the complexity of incorporating price information into prescribing decisions. Nevertheless, patients highlighted the potential value of accurate, real‐time information on medication costs to inform decision‐making.
ImportanceRising prescription drug costs and increasing prices for consumer goods may increase cost-related medication nonadherence. Cost-conscious prescribing can be supported by real-time benefit tools, but patient views on real-time benefit tool use and their potential benefits and harms are largely unexplored.ObjectiveTo assess older adults’ cost-related medication nonadherence, cost-coping strategies, and views on the use of real-time benefit tools in clinical practice.Design, Setting, and ParticipantsA weighted, nationally representative survey of adults aged 65 years and older administered via the internet and telephone from June 2022 to September 2022.Main Outcomes and MeasuresCost-related medication nonadherence; cost coping strategies; desire for cost conversations; potential benefits and harms from real-time benefit tool use.ResultsAmong 2005 respondents, most were female (54.7%) and partnered (59.7%); 40.4% were 75 years or older. Cost-related medication nonadherence was reported by 20.2% of participants. Some respondents used extreme forms of cost-coping, including foregoing basic needs (8.5%) or going into debt (4.8%) to afford medications. Of respondents, 89.0% reported being comfortable or neutral about being screened before a physician's visit for wanting to have medication cost conversations and 89.5% indicated a desire for their physician to use a real-time benefit tool. Respondents expressed concern if prices were inaccurate, with 49.9% of those with cost-related nonadherence and 39.3% of those without reporting they would be extremely upset if their actual medication price was more than what their physician estimated with a real-time benefit tool. If the actual price was much more than the estimated real-time benefit tool price, nearly 80% of respondents with cost-related nonadherence reported that it would affect their decision to start or keep taking a medication. Furthermore, 54.2% of those with any cost-related nonadherence and 30% of those without reported they would be moderately or extremely upset if their physicians used a medication price tool but chose not to discuss prices with them.Conclusions and RelevanceIn 2022, approximately 1 in 5 older adults reported cost-related nonadherence. Real-time benefit tools may support medication cost conversations and cost-conscious prescribing, and patients are enthusiastic about their use. However, if disclosed prices are inaccurate, there is potential for harm through loss of confidence in the physician and nonadherence to prescribed medications.
The concept of pharmaceutical promotion targeted at the public has been controversial throughout history for many clinicians, patients, and policymakers and has led to many regulatory changes for pharmaceutical promotion in the United States. The objective of this narrative review was to identify, assess, and summarize evidence addressing the potential impact of direct-to-consumer advertising (DTCA) on patient care through the lens of the quadruple aim of health care: (a) patient experience;(b) population health; (c) cost; and (d) provider experience. Increased spending on DTCA has frequently been cited in a negative context when discussing health policy due to inappropriate prescribing or increased spending on pharmaceuticals, but the research identified in this review describes a more complicated relationship. Any conclusions regarding the total impact on the health system will be greatly influenced by the perspective (eg, patient, provider, payer, society) of the person evaluating. In any case, benefits and harms of DTCA must be weighed in the context of the therapeutic area, population characteristics, and overall goal of the evaluator.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.