title: Elderly patients' preferences and experiences with providers in managing their drug costs.
abstract: OBJECTIVE
  To determine whether elderly patients with high drug expenditures want and receive providers' help in managing drug costs.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  A Medicare managed care plan (>400,000 members) in one state in 2002.
  
  
  METHODS
  One thousand one hundred six seniors (62% response rate) sampled so that half exceeded caps on their drug benefits the previous year, and all had total drug expenditures in the top quartile of members in their cap level.
  
  
  METHODS
  Participants' preferences and experiences with providers discussing costs and participation in choosing medications.
  
  
  RESULTS
  Two-thirds reported difficulty paying for medications, and one-fourth decreased medication use because of cost. Most wanted providers to ask about medication affordability (81%), consider cost (86%), offer choices (70%), and to persuade them or decide for them which medication to use (88%), but few said providers asked about affordability (17%), usually or always discussed prices (19%), or offered choices (45%), although nearly all said providers chose their medications (93%). Sixty-two percent had asked providers for help with drug costs, although 34% who used less medication because of cost or had difficulty paying for medications had not asked for help.
  
  
  CONCLUSIONS
  Providers should be aware that elderly patients want their help in managing drug costs but do not always receive it or ask for help when they need it. Providers could improve communication by initiating conversations about cost and by asking patients about preferences when prescribing.
authors.affiliation: Department of Family Medicine and Community Health, University of Hawaii, Honolulu, Hawaii, USA. cwtseng@hawaii.edu
authors.forename: Chien-Wen
authors.initials: CW
authors.lastname: Tseng
authors.forename: R Adams
authors.initials: RA
authors.lastname: Dudley
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brook
authors.forename: Emmett
authors.initials: E
authors.lastname: Keeler
authors.forename: W Neil
authors.initials: WN
authors.lastname: Steers
authors.forename: G Caleb
authors.initials: GC
authors.lastname: Alexander
authors.forename: Beth E
authors.initials: BE
authors.lastname: Waitzfelder
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mangione
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011306:Prescription Fees; D014481:United States