title: Medication costs: the role physicians play with their senior patients.
abstract: OBJECTIVE
  To determine how often primary care physicians discuss medication costs with their senior patients and what cost-reducing strategies they employ.
  
  
  METHODS
  Cross-sectional, random-sample mail questionnaire.
  
  
  METHODS
  State of California.
  
  
  METHODS
  Six hundred seventy-eight of 1,098 (62%) internal medicine and family practice physicians selected from the American Medical Association Masterfile.
  
  
  METHODS
  Main outcomes included frequency of cost discussions with senior patients in the previous 30 days and choice of cost-reducing strategy when a senior expresses financial difficulty with medication costs.
  
  
  RESULTS
  Forty-three percent of physicians reported discussing medication cost with at least half of their senior patients in the previous 30 days. Patients initiated most of these discussions. Forty percent reported that, at least one time in the previous 30 days, they had not discussed cost but wished they had. The most common reason given was "I ran out of time" (36%). Physicians with high perceived knowledge of medication costs were more likely to discuss cost (odds ratio (OR)=3.49, 95% confidence interval (CI)=1.66-7.3) versus low perceived knowledge, but this trend was not seen in physicians who scored high on actual knowledge of medication costs (OR=0.78, 95% CI=0.43-1.43) versus low actual knowledge. The most common cost-reducing strategies were generic substitution (33%) and offering samples (25%).
  
  
  CONCLUSIONS
  The frequency of medication cost discussions between physicians and senior patients is low, and when it occurs, is often initiated by patients. Physicians' perception of their knowledge of medication costs may be an important factor in initiating cost discussions.
authors.affiliation: Park Nicollet Institute, Health Research Center, Minneapolis, MN 55416, USA. beranm@parknicollet.com
authors.forename: Mary Sue
authors.initials: MS
authors.lastname: Beran
authors.forename: Marianne
authors.initials: M
authors.lastname: Laouri
authors.forename: Marika
authors.initials: M
authors.lastname: Suttorp
authors.forename: Robert
authors.initials: R
authors.lastname: Brook
mesh_terms: D000368:Aged; D002140:California; D003142:Communication; D003430:Cross-Sectional Studies; D004358:Drug Therapy / Q000191:economics*; D005260:Female; D006801:Humans; D007388:Internal Medicine; D008297:Male; D015999:Multivariate Analysis; D010361:Patients / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010821:Physicians, Family; D011306:Prescription Fees / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires