Can Physician Education Lower the Cost of Prescription Drugs?
A Prospective, Controlled Trial
- Linda M. Frazier, MD;
- J. Trig Brown, MD, MPH;
- George W. Divine, PhD;
- Gayle R. Fleming, RPh;
- Nancy M. Philips, MD;
- William C. Siegal, MD, MPH; and
- Moise A. Khayrallah, MA
Abstract
▪ Objective: To determine whether an educational program featuring a drug cost manual can assist physicians in reducing their patients' out-of-pocket prescription drug expenses.
▪ Design: Prospective controlled trial.
▪ Setting: A general internal medicine-teaching clinic in a university hospital.
▪ Participants: Fifty-one medical interns.
▪ Intervention: Thirty-one interns received a manual of comparative drug prices annotated with prescribing advice, two feedback reports, and weekly cost-oriented prescribing reminders. A control group concurrently participated in a manual-based educational program on cholesterol management.
▪ Measurements: Copies of 3012 prescriptions written over 8 months were analyzed.
▪ Main Results: Intervention group physicians prescribed less expensive drugs within classes of drugs. The change in drug price score per prescription was - 0.15 (95% Cl, - 0.27 to - 0.04; P = 0.01). A score of 3 was assigned to the most expensive, 2 was assigned to intermediate-priced, and 1 was assigned to the least expensive drug or drugs in the class. An increase of 0.74 months' (Cl, 0.49 to 0.98; P < 0.001) supply of medication was dispensed per prescription, reducing dispensing fees. The program was well accepted by the physicians.
▪ Conclusion: This relatively simple educational intervention can help physicians to reduce their patients' drug expenses and may serve as a model for incorporating cost information into the routine practice of medicine.
Article and Author Information
-
From Duke University Medical Center, Durham, North Carolina; and the School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. For current author addresses, see end of text.
-
Grant Support: In part by a grant from the Kate B. Reynolds Health Care Trust.
-
Requests for Reprints: Linda M. Frazier, MD, Box 2914, Duke University Medical Center, Durham, NC 27710.
-
Current Author Addresses: Dr. Frazier: Box 2914, Duke University Medical Center, Durham, NC 27710.
Dr. Brown: Box 3824, Duke University Medical Center, Durham, NC 27710.
Dr. Divine: Box 3040, Duke University Medical Center, Durham, NC 27710.
Ms. Fleming: Box 3089, Duke University Medical Center, Durham, NC 27710.
Dr. Philips: Community Health Center, 2 Maynard Street, Hanover, NH 03755.
Dr. Siegel: New England Deaconess Hospital, 185 Pilgrim Road, Boston, MA 02215.
Mr. Khayrallah: School of Education, Peabody Hall, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514.
- ©1991 American College of Physicians
Most Read
