Drug prices and third party payment: do they influence medication selection?

Area of Science:

• Health Economics
• Clinical Pharmacy
• Medical Decision Making

Background:

• Rising prescription drug costs impact healthcare systems.
• Physician prescribing behavior is influenced by various factors, including cost and insurance coverage.
• Understanding these influences is crucial for cost-effective prescribing.

Purpose of the Study:

• To investigate how third-party drug cost coverage and price information affect physicians' antibiotic selection.
• To determine if price reminders can moderate the tendency to choose expensive drugs when coverage is present.
• To analyze physician prescribing patterns for infectious exacerbation of chronic obstructive pulmonary disease (COPD).

Main Methods:

• A mailed survey was distributed to 1072 primary care physicians in Ontario.
• Physicians were presented with a clinical scenario and asked to select diagnostic tests and an antibiotic.
• Questionnaires varied in the inclusion of drug benefit coverage and price information.

Main Results:

• When third-party cost coverage was present and prices were shown, 18% of physicians chose an expensive antibiotic.
• This increased to 38% when prices were omitted, indicating a significant effect of price visibility (OR 2.72).
• When patients had no drug benefits coverage, expensive antibiotic selection decreased to 8% (OR 0.40).

Conclusions:

• Third-party drug cost coverage significantly increases the likelihood of selecting expensive antibiotics.
• Price information acts as a moderator, reducing the selection of costly drugs even with coverage.
• Interventions aimed at increasing price transparency can promote more cost-conscious prescribing.