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Physician Communication Regarding Cost When Prescribing Asthma Medication to Children

Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Michigan

Janet M. Coffman, PhD

Department of Family and Community Medicine, University of California, San Francisco, California, Department of Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California

Chien-Wen Tseng, MD, MPH

Department of Family Medicine and Community Health, University of Hawaii John A. Burns School of Medicine, Pacific Health Research Institute Honolulu, Hawaii

Noreen M. Clark, PhD

Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Michigan

Michael D. Cabana, MD, MPH

Department of Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, michael.cabana{at}ucsf.edu, Department of Pediatrics, University of California, San Francisco, California, Department of Epidemiology and Biostatistics, University of California, San Francisco, California

Children with asthma require multiple medications, and cost may be a barrier to care. The purpose of this study was to determine how often physicians ask about cost when prescribing new asthma medication and to identify factors influencing queries. We surveyed pediatricians and family physicians and asked whether they asked about cost when prescribing new asthma medication and if cost was a barrier to prescribing. One third of physicians (35%) reported that concern for cost to the family was a barrier to prescribing. Half reported not asking their patients about drug costs. Pediatricians were less likely to ask about cost (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.20-0.92) when compared with family physicians. For every 10% increase in the number of privately insured patients, a physician was less likely to ask about cost (OR = 0.83; 95% CI = 0.74-0.94). Communication about medication costs should be included in childhood asthma management.

Key Words: pediatrics • family medicine • asthma • physician—patient relations • prescription cost • communication barriers

This version was published on June 1, 2009

Clinical Pediatrics, Vol. 48, No. 5, 493-498 (2009)
DOI: 10.1177/0009922808330110


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