Seniors in search of drug guidance
Most seniors want doctors to talk to them about the cost of medications when they write a prescription but they don't ask, said a Hawaii researcher.
In the latest of a series of studies addressing problems seniors have with drug coverage, Dr. Chien-Wen Tseng said they "want help from their doctors to discuss costs and whether they can afford medications."
But only one in six of those who cut or stopped use of medications because of costs said their doctor asked if they could afford them, said Tseng, associate professor of medicine at the University of Hawaii's John A. Burns School of Medicine.
Her findings in a survey of 1,100 seniors were published in the December Journal of the American Geriatrics Society.
Tseng began studying problems confronting seniors with limited drug benefits as a UCLA Robert Wood Johnson clinical scholar before joining UH as a faculty member in 2002. She is also principal investigator with the Pacific Health Research Institute.
In a study published in September last year, she pointed out that seniors with Medicare drug plans could fall into a gap called a "doughnut hole" after drug costs reach $2,250. When that happens, they have to pay all drug costs out of pocket until reaching $5,100 or until coverage begins again at the start of the next calendar year.
About 23 million Medicare beneficiaries are enrolled in a drug plan, and it's estimated one in eight will fall into the doughnut hole, according to the Kaiser Family Foundation, she said.
Nearly all plans with any coverage for medicine during the gap cover only generic drugs, not brand-name drugs, the foundation reported.
Because of this, Tseng said, "It's even more important to ask doctors about medication benefits. ... They (seniors) should be talking on day one, not just whether they can afford medicines now but whether they are likely to hit the doughnut hole."
Tseng was one of 15 doctors nationally who received a four-year Robert Wood Johnson grant in 2004 for research to find ways to help people get prescriptions filled without giving up food and other essentials.
"I am just trying to make a difference," she said yesterday.
Tseng said she found most seniors prefer that their doctors make the final decision about medications. However, the patients often stop, skip or reduce use of medicine if they can't afford it.
"What was interesting, even among the two-thirds who had difficulty paying for medications, about one-half hadn't talked to their doctors," she noted. "They didn't ask for help. It's got to go both ways."
Most said they didn't discuss drug costs with their doctor because they didn't think the doctor could do anything, she said.
She found in an earlier study that doctors want to help patients but they have trouble knowing which drug to prescribe because there are so many Medicare drug plans and drug lists.
"Physicians say they would like to talk about cost but they have trouble getting information," she said.
"Health plans and insurers should consider how to make information on medication costs and drug benefits easily accessible to doctors as well as patients at the time of prescribing," she said.
