Doctors found unaware of drug costs

November 17, 1993|By Orlando Sentinel

LAKE BUENA VISTA, Fla. -- If you want to know the cost of that much-needed prescription drug you're about to buy -- don't look to your doctors for guidance.

Chances are they have only a vague idea or don't know at all. And don't be surprised if your pharmacist steps into the process, recommending cheaper generics or alternative medications.

A pair of surveys released this week in Orlando show that not only are doctors generally unaware of how much the medications they prescribe cost their patients, but pharmacists are intervening aggressively in the doctor-patient relationship to lower costs.

In a survey conducted by the University of Missouri, 100 family practitioners and internists came nowhere near guessing the price tags of the nation's 25 most frequently prescribed drugs.

In some instances, they underestimated the price of a medication by 70 percent or more.

Dr. Ashok Gumbhir released the survey results yesterday at the annual meeting of the American Association of Pharmaceutical Scientists.

Prescription costs are critical to a vast number of cost-conscious patients. But the survey showed that doctors rarely ask patients about prices or their ability to pay.

However, researchers at the University of Mississippi, in a survey to be released at the Orlando meetIng today, found that U.S. pharmacists change doctors' orders daily.

On average, they are changing doctors' orders 321,697 times a week -- occasionally to stiff opposition from physicians -- to sell patients cheaper generics or cheaper medicines that can do the same job but at lower cost.

Dr. Benjamin Banahan, associate director of health services research in the university's pharmacy school, found that an individual pharmacist averaged more than four such substitutions a week.

The survey found that 2 percent of all doctors strongly oppose pharmacists changing prescriptions.

Dr. Banahan cited mounting anger as the reason for the survey. Patients are complaining that their medicine costs too much, and pharmacists contend that manufacturers' pricing is astronomical and unrealistic.

The 439 pharmacists surveyed said they receive an average of 58 patient complaints a week.

Dr. Gumbhir said drug costs are high for several reasons.

A prescription that carries a $25 price tag, for example, includes $18 for the manufacturer and $6 for the pharmacy that fills the prescription. The remaining $1 is profit margin that goes either to the pharmacist or the manufacturer.

But the cost of any given medication can vary from pharmacy to pharmacy, which suggests that patients cannot depend on any one pharmacist to get the best deal.

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