title: Consumer attitudes and factors related to prescription switching decisions in multitier copayment drug benefit plans.
abstract: OBJECTIVE
  To examine patient attitudes related to formulary medications and medication-related decision making in multitier copayment prescription drug plans.
  
  
  METHODS
  A cross-sectional retrospective analysis.
  
  
  METHODS
  Data were collected via mail survey from a random sample of 25,008 members of a managed care organization. The selected members were enrolled in a variety of 2- and 3-tier copayment plans and were taking prescription medication to treat 1 or more of 5 chronic disease states.
  
  
  RESULTS
  Most respondents did not believe that formulary drugs were safer or more effective than nonformulary drugs, but 39.7% thought that formulary drugs were relatively less expensive. Most respondents appeared willing to consider switching from a nonformulary drug to a formulary drug with a lower copayment. The percent of respondents who reported they would be very unlikely or unlikely to switch was only 15.3% for a new prescription and 24.2% for a refill prescription. Medication efficacy and physician opinion were important factors in plan members' switching decisions. Cost was an important factor for some members, but older plan members were less likely to report that cost was important.
  
  
  CONCLUSIONS
  Multitier plan members generally believed that drugs are placed on the formulary for reasons of cost rather than safety or efficacy. Most plan members were receptive to switching from a nonformulary to a formulary medication, but financial incentives alone may not convince some plan members to make the switch.
authors.affiliation: College of Pharmacy, University of Iowa, Iowa City, Iowa 52242, USA. julie-urmie@uiowa.edu
authors.forename: Julie M
authors.initials: JM
authors.lastname: Ganther-Urmie
authors.forename: Kavita V
authors.initials: KV
authors.lastname: Nair
authors.forename: Robert
authors.initials: R
authors.lastname: Valuck
authors.forename: Marianne
authors.initials: M
authors.lastname: McCollum
authors.forename: Sonya J
authors.initials: SJ
authors.lastname: Lewis
authors.forename: Robin S
authors.initials: RS
authors.lastname: Turpin
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D003430:Cross-Sectional Studies; D003669:Deductibles and Coinsurance; D011307:Drug Prescriptions; D005260:Female; D005569:Formularies as Topic; D006302:Health Services Research; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D014481:United States