Despite high rates of health IT use, few Hawaii physicians are aware of the cost of medications they prescribe, and this impedes their ability to consider drug affordability for their patients, according to a new study.
The study, which was led by Chien-Wen Tseng, MD, associate professor at UH Mānoa's John A. Burns School of Medicine, surveyed 247 primary care physicians in Hawai'i in 2007 to find out how often they knew patients' out-of-pocket costs for medications when they wrote prescriptions.
Researchers found that more than 90 percent of physicians who participated in the study said lack of knowledge of formularies and copayments remained a barrier to considering drug costs for patients.
According to national reports, 26 percent of patients report nonadherence to medications because of cost.
The study found that approximately eight in 10 physicians regularly used IT in clinical care:
- 60 percent used the Internet,
- 54 percent used e-prescribing,
- 43 percent used electronic health records (EHRs), and
- 37 percent used personal digital assistants (PDAs).
Nearly two-thirds of physicians (62 percent) regularly used two or more IT types, according to the study.
"Specifically, we hoped that physicians who regularly use health information technology in clinical care would have better knowledge of drug costs. We found that only one in four physicians said they often knew drug costs, and rates weren't much higher even when physicians said they regularly used the Internet, electronic medical records, or electronic prescribing for patient care." said Tseng, a member of the Department of Family Medicine and Community Health.
In multivariate analyses (that adjusted for sex, practice size, years in practice, number of formularies, and use of clinical resources), use of the Internet—but not e-prescribing, EHRs, or PDAs—was associated with physicians reporting slightly better knowledge of copayments (adjusted predicted percentage of 23 percent vs. 11 percent; P = .04).
The study found that no type of IT was associated with better knowledge of formularies or retail prices.
Researchers said the study findings "should alert policymakers, insurers, and IT providers to reevaluate, as additional money is spent on health IT, the ability of current and future IT systems to successfully provide cost information to physicians at the point of care."
"Given the financial burden of drug costs on patients, there is a critical need to determine if the problem is that drug cost information is not adequately available via various types of IT, physicians are unaware of its availability, or physicians find such cost information too difficult to use," authors said.