PCPs, NPs, 'have responsibility' to inform patients of less expensive medications

PHILADELPHIA — Primary care physicians need to play a more active role in helping their patients get the best price for medications, according to a presenter here at the annual meeting of the American Association of Nurse Practitioners.

“We have a responsibility to not prescribe the most expensive medication to our patients just because a drug representative comes in with a coupon,” Peggy Vernon, RN, MA, DCNP, Alta Vista Dermatology, Highlands Ranch, Colorado, told Healio Family Medicine in an interview. “We need to be aware of what these drugs cost, we have to be effective in what we prescribe for them, but then we have to use the most economical medication that we can prescribe. We have to start containing costs in this health care system. We can’t rely on others to do that [for us].”

Vernon’s presentation focused on medications used to treat acne, which according to the American Dermatology Association is the most common skin condition in the United States, affecting up to 50 million people each year.

Vernon said that medications to treat dermatological conditions are experiencing the same price spikes that have been seen elsewhere in health care, most notably with the EpiPen.

“I’ve been giving this particular talk for about 5 years,” she said. “And from the first time I started this presentation until now, doxycycline has tripled in cost. That’s just not right. This is an old drug, there’s nothing new about it.”

She cited several tools that primary care physicians and other health care professionals can use to help their patients find the best prescription prices, including apps, such as Good RX, which doesn’t require insurance; over-the-counter options; coupon cards; and savings clubs offered by most major pharmacies.

Self-pay can sometimes be an affordable option too, she said.

“I prescribed a medication this week and the insurance wouldn’t cover it, so it would have cost the patient $300. I gave him a Good RX coupon and it cost him $20. We need to be aware of those kinds of differences and utilize them when we can.”

Some other examples of price differences that can be found by shopping around that Vernon cited included minocycline, which can cost $180 for 60 pills when purchased under the name brand at one pharmacy, but has been available on Good RX for as low as $28; and doxycycline extended release, which can cost $410 for 30 pills at a pharmacy for the name brand, but on Good RX, has been priced at $106. – by Janel Miller

Reference:

American Academy of Dermatology Webpage on Acne (accessed 06-19-2017)

Vernon P. Abstract 17.2.062. Presented at: American Association of Nurse Practitioners National Conference; Jun. 20-25, 2017; Philadelphia.

Disclosure: Vernon reports receiving speaking on behalf of Pfizer.