Physician awareness of prescription drug costs: a missing element of drug advertising and promotion

Journal of Family Practice, Jan, 1993 by Lucinda G. Miller, Alan Blum

Physicians have not shown substantial interest in the cost of medications. Medical schools, residency programs, postgraduate courses, and pharmaceutical company advertising and detailing seldom focus on this subject. There is a paucity of articles in the general medical literature on the cost of medications. This is all the more ironic and alarming when one considers the increasing attention by Congress and state legislatures to other health care concerns.

Inclusion of price information in promotional materials may help. The Director of the Food and Drug Administration (FDA) is in the best position to institute this change, but he has taken the position that the agency is concerned only with drug effectiveness, not cost. The role of the FDA in regulating drug advertising when camouflaged as scientific exchange has been the focus of recent discussion.[9-11] We propose that the FDA extend its role in pharmaceutical advertising by requiring that all advertisements include the average wholesale price of the drug or a cost index relative to other drugs used for similar indications. With 37% of the physicians who completed our survey overestimating medication costs, it may prove advantageous for some pharmaceutical companies to include price information in advertisements.

Most health care professionals and the general public will agree that pricing information related to prescription drugs should be more available. Just as important is the format in which such information should be presented. For the patient, the estimated retail cost for a given quantity would be a more meaningful figure, as price per unit may fail to communicate the magnitude of cost for the duration of therapy. Hence, we recommend that drug price information (wholesale or approximate retail cost) be provided covering the full course of therapy for acute conditions (eg, cost of 10 days of an antibiotic for an infection) and a month of therapy for chronic conditions (eg, cost of 30 days of a calcium channel blocker for hypertension).

Until not-for-profit resources such as Medical Letter, the Health Research Group, or Consumers Union are able to provide a comprehensive medication price guide for consumers, it may be left up to the initiative of concerned hospitals, clinics, and individual physicians to post such prices at nursing stations and drug sample closets. Ultimately, the FDA may be best suited to effectively address this issue on a large scale. In any case, it is time to move forward in raising medication cost consciousness.

References

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