title: Can patient demand for pharmaceuticals be moderated?
abstract: OBJECTIVE
  Ask health plan members whether they would consider switching to a less costly medication or alternative treatment if their physician asked.
  
  
  METHODS
  Random sample of 265 members of Kaiser Permanente in Northern California.
  
  
  METHODS
  A telephone survey asked participants to respond to three vignettes tailored to either men and women age 18 to 39, women age 40-80, or men age 40-80.
  
  
  RESULTS
  If asked to do so by their doctors, most young adults (77%) said they would be open to switching to a less expensive allergy medicine, most women over age 40 (60%) said they would try a less expensive blood pressure medication, and most men over age 40 (68%) said they would meet with a behavioral specialist and try other steps before taking ViagraAE. In open feedback, participants said they would be most receptive if the recommendation came from a trusted physician, if given the freedom to choose otherwise, and the alternative was equally effective and convenient. About one-third of participants expressed reservations or said they would definitely refuse substitution. These refusers were significantly less satisfied with the health plan, less satisfied with their primary care doctor, less trusting of Kaiser physicians in general, and in poorer health (as indicated in one or more vignettes).
  
  
  CONCLUSIONS
  Moderating patients' demand for pharmaceuticals can begin by physicians skillfully asking patients to consider a more cost-effective alternative to expensive medications when one is available.
authors.affiliation: Mark@Mark-Thompson.com
authors.forename: M
authors.initials: M
authors.lastname: Thompson
authors.forename: S
authors.initials: S
authors.lastname: Freedman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003362:Cost-Benefit Analysis; D003625:Data Collection; D011307:Drug Prescriptions / Q000191:economics*; D017850:Economics, Pharmaceutical; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D004364:Pharmaceutical Preparations / Q000191:economics; D010817:Physician-Patient Relations; D012737:Sex Factors; D013689:Telephone
chemical_list: D004364:Pharmaceutical Preparations