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Physician Awareness of Drug Cost: A Systematic Review

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  • G Michael Allan
  • Joel Lexchin
  • Natasha Wiebe

Abstract

Background: Pharmaceutical costs are the fastest-growing health-care expense in most developed countries. Higher drug costs have been shown to negatively impact patient outcomes. Studies suggest that doctors have a poor understanding of pharmaceutical costs, but the data are variable and there is no consistent pattern in awareness. We designed this systematic review to investigate doctors' knowledge of the relative and absolute costs of medications and to determine the factors that influence awareness. Methods and Findings: Our search strategy included The Cochrane Library, EconoLit, EMBASE, and MEDLINE as well as reference lists and contact with authors who had published two or more articles on the topic or who had published within 10 y of the commencement of our review. Studies were included if: either doctors, trainees (interns or residents), or medical students were surveyed; there were more than ten survey respondents; cost of pharmaceuticals was estimated; results were expressed quantitatively; there was a clear description of how authors defined “accurate estimates”; and there was a description of how the true cost was determined. Two authors reviewed each article for eligibility and extracted data independently. Cost accuracy outcomes were summarized, but data were not combined in meta-analysis because of extensive heterogeneity. Qualitative data related to physicians and drug costs were also extracted. The final analysis included 24 articles. Cost accuracy was low; 31% of estimates were within 20% or 25% of the true cost, and fewer than 50% were accurate by any definition of cost accuracy. Methodological weaknesses were common, and studies of low methodological quality showed better cost awareness. The most important factor influencing the pattern and accuracy of estimation was the true cost of therapy. High-cost drugs were estimated more accurately than inexpensive ones (74% versus 31%, Chi-square p

Suggested Citation

  • G Michael Allan & Joel Lexchin & Natasha Wiebe, 2007. "Physician Awareness of Drug Cost: A Systematic Review," PLOS Medicine, Public Library of Science, vol. 4(9), pages 1-11, September.
  • Handle: RePEc:plo:pmed00:0040283
    DOI: 10.1371/journal.pmed.0040283
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    Citations

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    Cited by:

    1. Luca Iaboli & Luana Caselli & Angelina Filice & Gianpaolo Russi & Eleonora Belletti, 2010. "The Unbearable Lightness of Health Science Reporting: A Week Examining Italian Print Media," PLOS ONE, Public Library of Science, vol. 5(3), pages 1-6, March.
    2. G Michael Allan & Christina Korownyk & Kate LaSalle & Ben Vandermeer & Victoria Ma & Douglas Klein & Donna Manca, 2010. "Do Randomized Controlled Trials Discuss Healthcare Costs?," PLOS ONE, Public Library of Science, vol. 5(8), pages 1-5, August.
    3. Gauri Billa & Karan Thakkar & Sarita Jaiswar & Dinesh Dhodi, 2014. "A Cross-Sectional Study to Evaluate the Awareness and Attitudes of Physicians Towards Reducing the Cost of Prescription Drugs, Mumbai," Applied Health Economics and Health Policy, Springer, vol. 12(2), pages 125-137, April.
    4. Barkowski, Scott, 2021. "Physician Response to Prices of Other Physicians: Evidence from a Field Experiment," MPRA Paper 108966, University Library of Munich, Germany.
    5. Magno, Cielo & Guzman, Ricardo Rafael S., 2019. "Drug price sensitivity among physicians in a developing healthcare system: Evidence from the Philippine market for statins and beta blockers," Economic Analysis and Policy, Elsevier, vol. 62(C), pages 268-279.
    6. Mousnad, Mohamed Awad & Shafie, Asrul Akmal & Ibrahim, Mohamed Izham, 2014. "Systematic review of factors affecting pharmaceutical expenditures," Health Policy, Elsevier, vol. 116(2), pages 137-146.
    7. Cedric Thomas Silveira, 2023. "Decoding a Doctor’s Prescription: A Study," Jindal Journal of Business Research, , vol. 12(1), pages 73-84, June.
    8. Stefanie Heinzle, 2012. "Disclosure of Energy Operating Cost Information: A Silver Bullet for Overcoming the Energy-Efficiency Gap?," Journal of Consumer Policy, Springer, vol. 35(1), pages 43-64, March.
    9. Lexchin, Joel, 2009. "Pricing of multiple dosage prescription medications: An analysis of the Ontario Drug Benefit Formulary," Health Policy, Elsevier, vol. 91(2), pages 142-147, July.
    10. Ida Iren Eriksen & Hans Olav Melberg & Berit Bringedal, 2013. "Norwegian Physicians’ Knowledge of the Prices of Pharmaceuticals: A Survey," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    11. Fraeyman, Jessica & Symons, Linda & De Loof, Hans & De Meyer, Guido R.Y. & Remmen, Roy & Beutels, Philippe & Van Hal, Guido, 2015. "Medicine price awareness in chronic patients in Belgium," Health Policy, Elsevier, vol. 119(2), pages 217-223.
    12. Mee-Lang Cheoun & Jongho Heo & Woong-Han Kim, 2021. "Antimicrobial Resistance: KAP of Healthcare Professionals at a Tertiary-Level Hospital in Nepal," IJERPH, MDPI, vol. 18(19), pages 1-13, September.
    13. D. Ackerly & Seth Glickman & Kevin Schulman, 2010. "Economic Content in Medical Journal Advertisements for Medical Devices and Prescription Drugs," PharmacoEconomics, Springer, vol. 28(5), pages 429-438, May.
    14. Rodríguez-Calvillo, Javier A. & Lana, Alberto & Cueto, Antonio & Markham, Wolfgang A. & López, Maria Luisa, 2011. "Psychosocial factors associated with the prescription of generic drugs," Health Policy, Elsevier, vol. 101(2), pages 178-184, July.
    15. Kunal Kulkarni & Sophie Shepherd, 2019. "Do we know the cost of orthopaedic care?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 71-86, January.

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