October 28, 2013
The Question
Do doctors consider patients ability to pay for drugs when writing prescriptions?
What we found
To date, most literature has found that doctors are sensitive to the financial incentives they themselves face, but often do not consider the financial constraints faced by their patients. This study examines the first commercial free-antibiotics program in the US, using zip code-level data on filled antibiotics prescriptions to determine whether the option of prescribing free generics affected doctors prescribing decisions.
We found that prescriptions for antibiotics increased by 4.8% in areas with the free-antibiotics program. Prescriptions written for covered generics increased by 7.6%, while those written for brands not covered by the program decreased by 4.1%,showing that physicians seem to consider their patients cost constraints when making prescribing decisions. There was also evidence of physicians substituting generics for brand-name drugs that don’t have generic equivalents.
Why it matters
This study indicates that, contrary to previous research, physicians do seem to take their patients ability to pay for medications into account when writing prescriptions. It also shows that free-antibiotics programs may raise total antibiotics prescriptions, which raises concerns about the unintended consequences of antibiotics overuse and increased antimicrobial resistance.
Featured image via sparktography/Flickr