Primary Care: Brief Training Encourages Discussions of Prescription Drug Costs

MedicalResearch.com Interview with:

Kevin Fiscella, M.D., M.P.H.Dean’s Professor, Family MedicineProfessor, Public Health Sciences and Community HealthUniversity of Rochester  Medical CenterCo-Director, Research DivisionDepartment of Family MedicineRochester, New York 14620

Dr. Fiscella

Kevin Fiscella, M.D., M.P.H.
Dean’s Professor, Family Medicine
Professor, Public Health Sciences and Community Health
University of Rochester  Medical Center
Co-Director, Research Division
Department of Family Medicine
Rochester, New York 14620 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The study was designed to determine whether one hour of training was sufficient to promote conversations between physicians and their patients regarding patient-borne costs of prescriptions.

We found that the training, which promoted a team-based approach involving brief screening and cost-reducing strategies, nearly doubled the number of conversations.

MedicalResearch.com: What should readers take away from your report? 

Response: Brief education on brief screening and practical strategies to lower prescription costs increases office visits discussion of prescription costs and strategies to reduce them.   

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Further questions are whether these effects are sustained and/or whether additional interventions are needed to produce larger and more sustained effects.

No disclosures

Citation:

Ann Intern Med. 2019 May 7;170(9_Supplement):S46-S53. doi: 10.7326/M18-2011.
Addressing Medication Costs During Primary Care Visits: A Before-After Study of Team-Based Training.
Carroll JK1, Farah S2, Fortuna RJ3, Lanigan AM4, Sanders M2, Venci JV5, Fiscella K5. 

https://www.ncbi.nlm.nih.gov/pubmed/31060055

May 11, 2019 @ 1:44 pm 

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Price of Existing Biologics Increased When New Drugs Entered Market

MedicalResearch.com Interview with:

Alvaro San-Juan-Rodriguez

Alvaro San-Juan-Rodriguez

Alvaro San-Juan-Rodriguez, PharmD
Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow
Pharmacy and Therapeutics
School of Pharmacy
University of Pittsburgh

MedicalResearch.com: What is the background for this study?

Response: Before 2009, etanercept (Enbrel®), infliximab (Remicade®), and adalimumab (Humira®) were the only tumor necrosis factor (TNF) inhibitors approved by the FDA for rheumatoid arthritis. Subsequently, 3 therapies gained FDA approval: subcutaneous golimumab (Simponi®) in April 2009, certolizumab pegol (Cimzia®) in May 2009, and intravenous golimumab (Simponi Aria®) in July 2013. All 6 agents are brand-name drugs.

Our study aimed to evaluate how the prices of existing TNF inhibitors (Enbrel®, Remicade® and Humira®) changed in response to the market entry of new TNF inhibitors.  Continue reading

Pressure To Produce Cheaper Generics Linked to More Hazardous Drug Recalls

MedicalResearch.com Interview with:
“pills” by Dominique Godbout is licensed under CC BY 2.0George P. Ball PhD
Operations and Decision Technologies Department
Kelley School of Business, Indiana University
Bloomington, IN 47405,

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We sought to examine how the intense pressure on firms to produce generic drugs more cheaply might influence product quality.

We find that the greater proportion of generic drugs a firm manufactures, the more severe product recalls they experience, because of an apparent relaxation of manufacturing quality standards. Additionally, they experience fewer less severe recalls, which may also result from forces of competition.

When the opportunity exists to not announce a recall that has high discretion, competition may lead firms to forgo the recall to avoid negative ramifications associated with recalls.

Continue reading

Costs of Generic Drugs for Heart Failure Can Vary Widely

MedicalResearch.com Interview with:

Paul J. Hauptman, MD</strong> Professor Internal Medicine, Division of Cardiology Health Management & Policy, School of Public Health

Dr. Paul Hauptman

Paul J. Hauptman, MD
Professor Internal Medicine, Division of Cardiology
Health Management & Policy, School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We decided to evaluate the cost of generic heart failure medications after an uninsured patient of ours reported that he could not fill a prescription for digoxin because of the cost for a one month’s supply: $100. We called the pharmacy in question and confirmed the pricing. At that point we decided to explore this issue more closely.

We called 200 retail pharmacies in the bi-state, St. Louis metropolitan area, 175 of which provided us with drug prices for three generic heart failure medications: digoxin, carvedilol and lisinopril. We found significant variability in the cash price for these medications. Combined prices for the three drugs ranged from $12-$400 for 30 day supply and $30-$1,100 for 90 day supply.

The variability was completely random, not a function of pharmacy type, zip code, median annual income, region or state. In fact, pricing even varied among different retail stores of the same pharmacy chain.

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Generic Drug Discount Programs More Valued By Vulnerable Populations

Dr. Song Hee Hong PhD Associate Professor, Health Outcomes and Policy Research Dept. Clinical Pharmacy University of Tennessee Health Science Center Memphis, TN 38163MedicalResearch.com Interview with:
Dr. Song Hee Hong PhD
Associate Professor,
Health Outcomes and Policy Research
Dept. Clinical Pharmacy
University of Tennessee Health Science Center
Memphis, TN 38163

Medical Research: What are the main findings of the study?

Dr. Hong: Use of GDDP (generic drug discount programs) increased to 23.1% in 2010 from 3.6% of patients receiving any prescription drugs in 2007.

Generic drug discount programs were more valued among the elderly, sicker and uninsured populations.

The lower use of Generic drug discount programs among racial/ethnic minorities observed when the program was deployed no longer existed when the program matured.
Continue reading