"This represents a relatively... small component of overall medication nonadherence" the paper states, but it notes that "every essential prescription abandoned could represent an important clinical concern" if the patient isn't appropriately medicated.
The researchers also note that physicians need to be more aware of their patients' co-pays and discuss the cost with them before the patient heads to the drug store. That exchange, they say, "may reduce abandonment rates." But they also point out that physicians are often unaware of cost issues.
Allison Rosen, a fellow at University of Michigan's Center for Value Based Insurance Design and associate professor at the University of Massachusetts Medical School, agrees with the researchers: Cost is often not at the forefront of the physician's mind; There are too many competing clinical demands, she tells HealthLeaders Media. "It's just a given," she says, that most physicians don't discuss costs. But she sees that changing?largely because cost issues are so prominent in the headlines.
The paper's authors suggest that use of EHRs may facilitate such discussions.
They also point out that benefit designs that reduce cost-sharing for the most effective medications (i.e., value-based insurance design) could reduce abandonment rates. Rosen, an advocated of VBID, concurs. The goal, she explains, is to make the most important drugs affordable?to remove barriers to high-value therapies. (The flip side, she notes, is to increase barriers to therapies of low value.)