title: Racial differences in beliefs of physician prescribing practices for low-cost pharmacy options.
abstract: BACKGROUND
  Previous studies have reported that certain populations are sensitive to high out-of-pocket drug costs, and drug noncompliance leads to poorer health outcomes.
  
  
  OBJECTIVE
  Our aim was to measure patient awareness of discount pharmacy options, cost barriers to medication access, and beliefs about health care provider's use of low-cost medications.
  
  
  METHODS
  This cross-sectional 17-item survey was administered to patients in the emergency department of an urban trauma center in February 2011. Differences in responses by sex and race groups were assessed. A logistic regression model was created to estimate the association of sociodemographic factors and medication use with awareness of discount pharmacy options.
  
  
  RESULTS
  Five hundred and fifty-two surveys were analyzed. Among respondents who were prescribed medications within the past year, three fourths of patients felt comfortable asking physicians for cheaper medicines. Slightly more than half were aware of low-cost pharmacy options, and 78% of these respondents correctly listed at least one of these pharmacies. Caucasian patients were more comfortable than African American patients asking for cheaper medicines (82.5% vs. 72.2%; p < 0.05) and were more aware of low-cost prescription programs (63.9% vs. 43.5%; p < 0.001). When adjusted for insurance status and current medication use, Caucasian patients were 2.7 times more likely to name a valid discount pharmacy option compared to African Americans (95% confidence interval 1.85-4.07).
  
  
  CONCLUSIONS
  This study suggests populations may be more uncomfortable initiating a discussion about medication costs and selection of lower-cost alternatives. Health care providers may need to develop communication strategies in which medication cost is addressed with sensitivity and consistency.
authors.affiliation: Division of Emergency Medicine, Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Preeti
authors.initials: P
authors.lastname: Dalawari
authors.affiliation: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Niral M
authors.initials: NM
authors.lastname: Patel
authors.affiliation: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: William
authors.initials: W
authors.lastname: Bzdawka
authors.affiliation: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Jessica
authors.initials: J
authors.lastname: Petrone
authors.affiliation: Saint Louis University School of Medicine, Saint Louis, Missouri.
authors.forename: Victor
authors.initials: V
authors.lastname: Liou
authors.affiliation: Saint Louis University Center for Outcomes Research, Saint Louis, Missouri.
authors.forename: Eric
authors.initials: E
authors.lastname: Armbrecht
mesh_terms: D000328:Adult; D001741:Black or African American; D017046:Cost Savings / Q000191:economics*; D003430:Cross-Sectional Studies; D016568:Drugs, Generic / Q000191:economics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007356:Insurance, Pharmaceutical Services; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010594:Pharmacies / Q000191:economics; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000191:economics; D055553:Prescription Drugs / Q000191:economics*; D011306:Prescription Fees; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D016568:Drugs, Generic; D055553:Prescription Drugs
keywords: cost barriers; low-cost pharmacy options; medication noncompliance; patient beliefs; racial differences