Many Medicare patients are not discussing with their physicians important aspects of their prescription medications, including how much they cost.
That finding is outlined in a new study by the Commonwealth Fund and the Kaiser Family Foundation. The study looked at physician-patient communication involving Medicare beneficiaries in all 50 states.
Some 40 percent of seniors surveyed reported not following their doctors' orders on prescription drugs. Of those, 39 percent in that group never discussed financial matters with a physician, the report said. In most cases, lower-cost drug plans or prescriptions were available.
The study noted that physicians have "a number of cost-reducing strategies available," including using generic drugs, reducing doses and giving samples to patients. These cost-reducing strategies can't be used if physicians and patients are not routinely discussing medication use and costs, the report stressed.
"Most drugs now have a lot of options in a class, many of which are often generic," said lead author Ira Wilson, MD, Tufts-New England Medical Center. "The physician now has a big ability for controlling costs."
Wilson said that, while it's not physicians' job to correct all problems related to consumers' inability to pay for drugs, they could make an expanded effort to discuss drug issues such as cost, side effects and efficacy with seniors.
"I ask (Medicare patients), 'Are these drugs working? What do these drugs cost you?' I don't think there is a lot about their costs that I don't know, but I know because I ask," he said. "There is no justification whatsoever for not discussing whether a drug works or has side effects."
Communication could be improved by quality measurement and quality improvement initiatives focusing on prescription drug-related communication, the report suggested.
"What both physicians and patients need to do is come clean on all this stuff, put it out on the table," Wilson said. "They need to expect that this is going to be a subject of discussion every time there is a visit."