Compliance vs. Cost

The cost of medication for patients is often times the barrier between being compliant with physician recommendations. In an Archives of Internal Medicine Journal Sept. 2006, the survey found that 85% of patients are noncompliant with physician recommendations. Sixty seven percent are chronically ill and skip medications to save money and do not inform their physicians. Thirty five percent do not discuss their noncompliance and 32% were middle aged, noncompliant because of cost and noted their health to significantly decline in the past 2 years.

Physicians get on the average 5 phone calls daily from pharmacies about drugs being non-formulary and more than 18 calls daily for drugs that are not preferred. For our office, this means we have 20 calls for non-formulary changes and more than 90 for non-preferred drugs.

This is a huge burden to running an office and trying to treat the patients. Drugs are prescribed based on what we feel is best for the patient and not what is best for the insurance company’s formulary and bottom line.

The current system puts a huge strain on patients and physicians while the drug and insurance companies continue to make it ever more increasingly difficult. Some physicians are refusing to change prescriptions and places the complete burden back on the patient. Others try and compromise, but patients need to understand what their insurance covers and what it does not.

The insurance company doesn’t care about the patient if the required treatment falls outside of their coverage.