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Dermatology providers, residents underestimate costs of medications

Dermatology providers and residents underestimated the costs of medications commonly prescribed for dermatologic procedures, according to study results recently published in the Journal of the American Academy of Dermatology.

Researchers developed three surveys for dermatology providers, residents and patients, which primarily used a 4 or 5 option Likert scale. The study populations were recruited between October 2010 and January 2011 in Portland, Oregon.

Providers (n = 54; 54% female) included MD, DO, NP and PA dermatology providers in academic and private practices. Residents (n = 48; 70% female) were recruited by contacting the chief residents from the dermatology departments at Oregon Health & Science University, University of Washington, University of California, San Francisco and Stanford University. Patients (53% female) were recruited from the Oregon Health & Science University general dermatology clinic and local private practices.

The surveys were administered by mail or in person. All three survey populations had response rates over 95%.

There was consistent underestimation of the costs of commonly recommended dermatologic medications by dermatology providers and residents, with average absolute percent error of medication cost estimates of 52% for providers and 60% for residents. Providers more accurately estimated the costs of procedures.

When potassium hydroxide was removed as a value, residents had an average absolute percent error of 48% when estimating the costs of procedures. Residents were more likely to underestimate medication costs and more likely to overestimate procedure costs. Regarding costs, residents reported receiving very little formal training.

Patients reported that discussing costs of medications was important to them, even when the costs were covered by insurance. More than 25% of patients reported not filling prescriptions due to costs or using less than the prescribed amount.

“Dermatology providers rarely know the costs of commonly used medications,” the researchers concluded. “Dermatology providers are much more likely to discuss the costs of care if they believe the care will not be covered by insurance. Patients, however, express interest in knowing all costs including those that will be covered by insurance.

“The data also show that costs of care influence patient behavior, and non-adherence due to cost might be contributing to poorer outcomes and increased overall health care expenditures.”  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.