Physician Behavior Impacts Patient Adherence, For Good and Bad
By Sarah Mayer

It is well known that half of all patients do not take their medication as prescribed. Poor compliance results in over 125,000 patient deaths every year, and costs the healthcare system approximately $300 billion in preventable doctor visits, emergency room admissions, and hospitalizations. These statistics come from the New England Journal of Medicine and the National Institutes of Health.

With the high costs of prescriptions a significant deterrent to patient adherence, we decided to ask physicians if and when they discuss medication pricing with their patients, and what they thought about pharma-sponsored patient support programs. We surveyed 270 physicians working in a range of disciplines, with an average of 15 years professional experience.

As one internal medicine practitioner in Wisconsin with 17 years in practice said, “if patients cannot pay for a prescription, it cannot help them.” Almost all of the physicians reported drug costs as a large consideration.  

Questions About Generics


Our study revealed lingering uncertainties within the healthcare community about the effectiveness of less expensive drugs. While almost 40% of physicians reported that they always prescribe the most effective, lowest cost drug, 24% admitted to being unsure whether certain manufacturer’s generics are superior to others. 

This will be an important attitude to watch as healthcare costs loom in public policy debates, and biosimilars advance in therapeutic areas like cancer, rheumatology, and dermatology.

Pharma-Supported Patient Programs

Only 19% of physicians felt well informed regarding pharmaceutical patient support programs. According to the American Journal of Managed Care, these coupon and rebate programs allow patients to save over $600 on average, making them vital to patients’ ability to obtain their prescriptions and to the improved outcomes that come with prolonged treatment. More research is needed to determine the resources available to notify physicians of patient medication subsidy opportunities, as well as to better understand the barriers to physician education regarding these programs.

More Expensive Drugs Can Increase Adherence

Adherence is more complicated than simply being able to afford or prescribe the lowest priced medication. As it turns out, some physicians reported that a higher prescription price in some cases incentivized patients to be more adherent to treatment. One pediatrician in Kentucky with 32 years in practice stated, “If a patient has history of noncompliance, I’ll consider a more expensive medicine.”

Several physicians offered that patients may not feel invested in treatments that are easily affordable, and a higher price point could help patients stay on track with their healthcare goals.

Overall, physicians recognize the importance of low cost medications in empowering patients to stay on their treatment plans and manage their own health, but more work must be done to allow practitioners to better support patients in obtaining prescription assistance and to prescribe generic drugs with confidence.

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