Addressing Medication Costs During Primary Care Visits: A Before-After Study of Team-Based Training

Area of Science:

• Health Services Research
• Primary Care Medicine
• Patient Financial Toxicity

Background:

• Patients frequently face out-of-pocket costs for medications.
• Clinicians often do not screen for patients' cost-of-medication (COM) concerns.
• Addressing medication costs is crucial for patient adherence and financial well-being.

Purpose of the Study:

• To evaluate the impact of a single training session on clinician-patient conversations regarding medication costs.
• To assess the feasibility and effectiveness of a team-based approach to screening and addressing COM concerns.

Main Methods:

• A before-after study design was employed across 7 primary care practices.
• 700 patients completed surveys pre- and post-intervention, with qualitative interviews conducted with 45 staff members.
• A single 60-minute training session focused on COM importance, team-based screening, and cost-saving strategies.

Main Results:

• COM discussions increased from 17% to 32% post-intervention (P < 0.01), with improvements seen in 6 of 7 practices.
• Qualitative data revealed significant variation in implementation of screening, team-based approaches, and cost-saving strategies.
• Patient-reported out-of-pocket medication costs showed heterogeneity in changes across sites.

Conclusions:

• A single training session can improve short-term patient-clinician discussions about medication costs.
• Further research is necessary to determine the sustainability of these improvements.
• The study underscores the need to investigate the impact on patient costs and adherence, and to explore scalable interventions.