Cost-consciousness among Swiss doctors: a cross-sectional survey

Bovier, Patrick A.; Martin, Diane P.; Perneger, Thomas

doi:10.1186/1472-6963-5-72

Cited by 40 publications

(50 citation statements)

References 31 publications

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“…With this validated costconsciousness scale, we found that doctors had a mean score of 17.8 (SD 2.3), which was slightly higher than that reported in previous studies from Switzerland (Geneva; 16.8, SD 3.6) [14] and the USA (Ann Arbor, Michigan; 17.2, SD 3.1) [15]. The students had lower scores (15.6, SD 3.2) than the doctors in the current and two earlier studies [14,15]. Although cost consciousness is considered important, previous studies did not find an association between the acknowledged importance of costs and awareness of actual costs [18,19].…”

Section: Discussioncontrasting

confidence: 46%

“…Cost consciousness has not been evaluated previously among medical students, and although the importance of cost consciousness among doctors has been reported earlier, it has only been measured twice with a validated instrument [14,15]. With this validated costconsciousness scale, we found that doctors had a mean score of 17.8 (SD 2.3), which was slightly higher than that reported in previous studies from Switzerland (Geneva; 16.8, SD 3.6) [14] and the USA (Ann Arbor, Michigan; 17.2, SD 3.1) [15]. The students had lower scores (15.6, SD 3.2) than the doctors in the current and two earlier studies [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Survey questions were organized in three sections: attitude to costs, cost awareness/cost estimations and prescribing habits regarding drug costs in daily practice. Attitude to costs was measured with a validated cost-consciousness scale that probed attitudes towards cost in general, and more specifically on medication and diagnostics (table 1) [14,15]. Two items investigate doctors' opinions about healthcare costs in general, and three items investigate their attitudes regarding the costs of tests and procedures (the last item probes the importance of out-of-pocket payments).…”

Section: Methodsmentioning

confidence: 99%

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Students and Doctors are Unaware of the Cost of Drugs they Frequently Prescribe

Schutte

Tichelaar

Nanayakkara

et al. 2016

Basic Clin Pharma Tox

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Given the increasing healthcare costs of an ageing population, there is growing interest in rational prescribing, which takes costs of medication into account. We aimed to gain insight into the attitude to and knowledge of medication costs of medical students and doctors in daily practice. This was a cross-sectional electronic survey among medical students (bachelor/master) and doctors (consultants/registrars). Attitude to costs was evaluated using a cost-consciousness scale. In open questions, the participants estimated the cost of commonly prescribed (generic/non-generic) drugs (including separate pharmacy dispensing costs). They were asked where they could find information about drug costs. Overall, a reasonable cost-consciousness was found. Students were less conscious of the cost than were doctors (15.56 SD 3.25 versus 17.81 SD 2.25; scale 0-24; p = 0.001). In contrast to this consciousness, actual estimated drug costs were within a 25% margin for only 5.4% of generic and 13.7% of proprietary drugs (Wilcoxon signed-rank, p < 0.001). The price of generic drugs was frequently overestimated (77.5%) and that of proprietary drugs was underestimated (51.4%). The dispensing costs were estimated correctly for 30% of the drugs. Most doctors (84%) and a minority of students (40%) were able to identify at least one source of information about drug costs. While doctors and students considered it important to be aware of the cost of drugs, this attitude is not reflected in their ability to estimate the cost of frequently prescribed drugs. Cost awareness is important in therapeutic reasoning and cost-effective prescribing. Both should be better addressed in (undergraduate) pharmacotherapy education.Approximately €200 billion is spent on medicines and drugs annually, about 16-17% of the total healthcare expenditure in the EU [1]. These costs must be controlled to keep health care affordable, especially in today's ageing society with its increased care consumption [2]. Besides the importance of pharmacoeconomics to society in general, it is becoming increasingly important for hospitals, doctors and individual patients. Depending on the country and type of medical insurance, patients have to pay certain costs (i.e. deductible excess in the Netherlands) [3], and doctors and hospitals are under pressure from health insurance companies and governmental institutions to take medication costs into consideration, for instance, by prescribing generic rather than proprietary drugs [4]. The drive to contain costs is focused not only on therapeutics, but also on reducing, often unnecessary, diagnostics. In this diagnostic field, studies have shown that doctors who are aware of test costs order fewer tests [5,6].Rational prescribing includes comparing the efficacy, safety, suitability and cost of treatment options, according to the WHO guide to good prescribing [7]. The WHO guide to good prescribing and the associated six-step guideline are internationally used to teach pharmacotherapy to future prescribers [8]. Currently, ph...

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Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Students and Doctors are Unaware of the Cost of Drugs they Frequently Prescribe

Schutte

Tichelaar

Nanayakkara

et al. 2016

Basic Clin Pharma Tox

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“…Medical prescriptions are therefore meant to be more considered and more reasonable. More and more doctors feel that costs are an important consideration in the medical thought process that leads to prescribing decisions [13,14].…”

Section: Introductionmentioning

confidence: 99%

Cost awareness of physicians in intensive care units: a multicentric national study

et al. 2015

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“…Concerns about rising costs of health care are felt by health care professionals around the world (Rosen & Karlberg 2002;Bovier et al, 2005;Robertson et al, 2011) leading to pressure to deliver services in the most cost effective way possible. As new diagnostic tests, surgical procedures or more effective drugs are developed, there is, at least in developed countries, an imperative to make these things available to all, inevitably at an increased cost to the system.…”

Section: Introductionmentioning

confidence: 99%