Practical tips, pearls help ease patients’ financial burdens

Physicians must be willing to drive financial discussions with their patients. Too many patients who are struggling financially to pay for medications won’t initiate the conversation.

Reviewed by Yvonne Ou, MD

Physicians often are faced with walking a tightrope of providing services without placing undue financial burdens on their patients. Yvonne Ou, MD, is an associate professor, co-director of the Glaucoma Service, and Vice Chair for Postgraduate Education in the Department of Ophthalmology, UCSF.

She specializes in treating glaucoma with medical, laser and surgical therapies. During the recent American Glaucoma Society annual meeting, she presented “Practical Tips and Tricks to Ease Your Patients’ Financial Burdens.” She shared ways a physician can help his or her patients with the cost of medications.

“We must talk to our patients and consider switching medication class,” she stated. Virtually every practice must deal with prescription issues. Prescription drug costs are a pressing concern for both physicians and patients. Rising drug prices affect patients’ out-of-pocket costs as well as the budgets of private and public payers, though the challenges can vary by payer.

Physicians are the front line of treatment and you can encourage patients to shop around and talk to their pharmacists.

“I think the take home message is that we need to be the ones initiating these discussions,” she said, noting that about half of patients facing financial issues with prescription costs will not broach the subject with their physician.

If a patient is not getting the needed medications, treatment of an ongoing condition can be impeded. Glaucoma is a lifelong disease, and physicians must work with their patients to create a treatment plan that is sustainable over the long term.

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This can lead to a search for more affordable options, including the large retailers. However, lists of $4 per month eye drops at places like Walmart can change from year to year. She urged physicians to encourage patients to shop around. They can use websites to compare prices.

They also can print coupons. “There is a little caveat to that and that is the coupons overall may not be helping costs within our healthcare system, but at least at the time that the patient purchases the medication, coupons will help them,” she said. Some independent pharmacies can sometimes offer good deals to patients who pay cash.

Patients can often buy their medications online, for example patients might want to go to Canada or abroad. It is important that they determine which online pharmacies are reputable.

Encourage patients to talk to the pharmacists, since pharmacists can now discuss how to reduce their medication costs, she said. A recent study examined the frequency and magnitude of copayments and prescription drug costs. It analyzed prices of 1.6 million people paying for 9.5 million prescriptions.

“They found that patients would have been better off paying cash 23% of the time,” she said. “And the average overpayment is $8.” Special programs are another area where you can help your patients. Drug manufacturers also provide patient assistance programs, although patients often need help with determining eligibility and paperwork.

“In my limited experience, they do not provide patient advocates directly,” she said. “But the folks on the phone are actually quite helpful in helping navigate the system.”

Finally, laser trabeculoplasty is a very effective option as a first-line treatment, as a recent UK study demonstrated. She also noted that bilateral laser trabeculoplasty was less expensive than a three-year supply of medications in 71% of developing countries.

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Disclosures:

Yvonne Ou, MD
P: 415/476-0779 E: yvonne.ou@ucsf.edu
This article was adapted from Dr. Ou’s presentation at the 2019 meeting of the American Glaucoma Society. Dr. Ou has no financial disclosures related to this article to release.