Cost awareness when prescribing treatment

Abstract

Aim: Healthcare organisations are constantly faced with the need to contain medical costs. Healthcare institutions expect practitioners to keep costs low, while providing patients with the best possible medical care. This study examines the attitudes of doctors to considering costs, while prescribing medical tests and treatment. Methods: Investigators submitted a 55-item questionnaire to 200 primary care practitioners in health maintenance organisations in Israel, in which14 questions addressed practitioners' attitudes to cost considerations. Results: Attitudes to cost containment depended on practitioners' awareness of costs, whether they were internists or family practitioners, and whether they participated in seminars on healthcare costs. Seniority had no bearing on attitude. Practitioners born in the former USSR knew more about the costs of inpatient hospital stay, whereas Israeli-born physicians were more aware of the costs of emergency room visits. Family practitioners, interns, and gynaecologists were equally aware ofthe costs of medications. Practitioners in administrative roles, unlike those who were not, thought that financial considerations are detrimental to a patient's health. Conclusions: Further education by the healthcare organisation would keep practitioners updated on medical advances, and familiarise them with unique contracts and costs. This would enable practitioners to feel more involved, and to understand the necessary economic considerations relevant to treating illnesses.

Patient-level information and costing systems (PLICSs): a mixed-methods study of current practice and future potential for the NHS health economy

“…57,129 This medical manager model was successful in imbuing key senior clinicians with some cost awareness. 57,130,131 As discussed earlier, SLR/SLM builds on the natural allegiances of clinicians to their specialties. But, if specialties become fully fledged 'business units', with an outlook focused on cost improvement and the 'bottom line', this could impede other key health policy objectives, such as integrated services and more care in the community.…”

General practitioners' views on using a prescribing substitution application (ScriptSwitch®)

“…19,33,38,40 As results indicate, simple cost-cutting substitutions such as generic prescribing are largely in place, 23 and further cost-cutting is increasingly difficult despite GPs welcoming cost-information. 1,17,18 Practitioners must make decisions on whether potentially small therapeutic benefits for individual patients are worthy of large costs to larger patient groups, 14,18 creating tensions and ethical dilemmas. 17,41,42 A utilitarian ethical perspective would permit cost-reduction to maximise limited resources to benefit the most 42 ; however, GPs face pressure from individual patient demands and choices.…”

“…Drug cost information has been shown to be a modifiable factor in altering prescribing behaviour and welcomed by GPs. 1,17,18 Factors relating to the application itself are important in its success for change, but 'human factors' also contribute. 19 It is important to explore GPs' experiences as application users who understand the context and consequences of utilising it in day-to-day clinical practice: aspects which can be poorly understood by those designing such tools.…”

Norwegian Physicians’ Knowledge of the Prices of Pharmaceuticals: A Survey

“…Other researchers have also been interested in the relationship between knowledge of the cost of treatments and other variables [17,19]. Ernst et al criticised earlier studies on the subject of physicians’ knowledge of costs as having limited generalisability, because the drugs included in questionnaires were not necessarily routinely prescribed by the responding physicians [16].…”