Racial Differences in Beliefs of Physician Prescribing Practices for Low-Cost Pharmacy Options

• Published in: The Journal of emergency medicine Vol. 46; no. 3; pp. 396 - 403
• Main Authors: Dalawari, Preeti, MD, MSPH, Patel, Niral M., BS, Bzdawka, William, PharmD, Petrone, Jessica, BS, Liou, Victor, BS, Armbrecht, Eric, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2014
• Subjects: Adult; African Americans; cost barriers; Cost Savings - economics; Cross-Sectional Studies; Drugs, Generic - economics; Emergency; European Continental Ancestry Group; Female; Health Knowledge, Attitudes, Practice - ethnology; Humans; Insurance, Pharmaceutical Services; low-cost pharmacy options; Male; Medication Adherence; medication noncompliance; Middle Aged; patient beliefs; Pharmacies - economics; Physician-Patient Relations; Practice Patterns, Physicians' - economics; Prescription Drugs - economics; Prescription Fees; racial differences; Surveys and Questionnaires; medication noncompliance; patient beliefs; cost barriers; low-cost pharmacy options; racial differences
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2013.08.034

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.