Abstract
Background
Medication cost conversations occur less frequently than patients prefer, and it is unclear whether patients have positive experiences with them when they do occur.
Objective
To describe patients’ experiences discussing their medication costs with their health care team.
Design
Cross-sectional survey.
Setting
Nationally representative survey fielded in the United States in 2022 (response rate = 48.5%).
Patients
1020 adults over age 65.
Measurements
Primary measures were adapted from Clinician and Group Consumer Assessment of Healthcare Providers Survey visit survey v4.0 and captured patients’ experiences of medication cost conversations. Additional measures captured patients’ interest in future cost conversations, the type of clinicians with whom they would be comfortable discussing costs, and sociodemographic characteristics.
Results
Among 1020 respondents who discussed medication prices with their health care team, 39.3% were 75 or older and 78.6% were non-Hispanic White. Forty-three percent of respondents indicated that their prior medication cost conversation was not easy to understand; 3% indicated their health care team was not respectful and 26% indicated their health care team was somewhat respectful during their last conversation; 48% indicated that there was not enough time. Those reporting that their prior discussion was not easy to understand or that their clinician was not definitely respectful were less likely to be interested in future discussions. Only 6% and 10% of respondents indicated being comfortable discussing medication prices with financial counselors or social workers, respectively. Few differences in responses were observed by survey participant characteristics.
Limitations
This cross-sectional survey of prior experiences may be subject to recall bias.
Conclusion
Among older adults who engaged in prior medication cost conversations, many report that these conversations are not easy to understand and that almost one-third of clinicians were somewhat or not respectful. Efforts to increase the frequency of medication cost conversations should consider parallel interventions to ensure the discussions are effective at informing prescribing decisions and reducing cost-related medication nonadherence.
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Data Availability
Data available upon request.
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The Robert Wood Johnson Foundation.
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Conflict of Interest
Dr. Dusetzina is a member of the Institute for Clinical and Economic Review (ICER) Midwest Comparative Effectiveness Public Advisory Council and served on the National Academy of Sciences, Engineering, and Medicine Committee “Ensuring Patient Access to Affordable Drug Therapies.” She serves on the Medicare Payment Advisory Commission. The views expressed in this article are the author’s own and do not reflect the view of the Commission. Dr. Mattingly reports grant support from the U.S. Food and Drug Administration, National Institute on Minority Health and Health Disparities, and PhRMA Foundation and consulting fees from the Arnold Foundation and PhRMA unrelated to this work. Dr. Everson is employed by the Data Analysis Branch, Office of the National Coordinator for Health Information Technology, Department of Health and Human Services. The opinions expressed in this article are the author’s own and do not reflect the view of the Office of the National Coordinator for Health Information Technology, the National Institutes of Health or the National Cancer Institute, the Department of Health and Human Services, or the United States Government.
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This work was presented in poster form at the June 2023 AcademyHealth Annual Research Meeting, Seattle, WA.
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Everson, J., Besaw, R.J., Whitmore, C.C. et al. Quality of Medication Cost Conversations and Interest in Future Cost Conversations Among Older Adults. J GEN INTERN MED 38, 3482–3489 (2023). https://doi.org/10.1007/s11606-023-08388-w
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DOI: https://doi.org/10.1007/s11606-023-08388-w