Academia and Clinic
15 July 1991

Can Physician Education Lower the Cost of Prescription Drugs?: A Prospective, Controlled Trial

Publication: Annals of Internal Medicine
Volume 115, Number 2


▪ Objective: To determine whether an educational program featuring a drug cost manual can assist physicians in reducing their patients' out-of-pocket prescription drug expenses.
▪ Design: Prospective controlled trial.
▪ Setting: A general internal medicine-teaching clinic in a university hospital.
▪ Participants: Fifty-one medical interns.
▪ Intervention: Thirty-one interns received a manual of comparative drug prices annotated with prescribing advice, two feedback reports, and weekly cost-oriented prescribing reminders. A control group concurrently participated in a manual-based educational program on cholesterol management.
▪ Measurements: Copies of 3012 prescriptions written over 8 months were analyzed.
▪ Main Results: Intervention group physicians prescribed less expensive drugs within classes of drugs. The change in drug price score per prescription was - 0.15 (95% Cl, - 0.27 to - 0.04; P = 0.01). A score of 3 was assigned to the most expensive, 2 was assigned to intermediate-priced, and 1 was assigned to the least expensive drug or drugs in the class. An increase of 0.74 months' (Cl, 0.49 to 0.98; P < 0.001) supply of medication was dispensed per prescription, reducing dispensing fees. The program was well accepted by the physicians.
▪ Conclusion: This relatively simple educational intervention can help physicians to reduce their patients' drug expenses and may serve as a model for incorporating cost information into the routine practice of medicine.

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Information & Authors


Published In

cover image Annals of Internal Medicine
Annals of Internal Medicine
Volume 115Number 215 July 1991
Pages: 116 - 121


Published in issue: 15 July 1991
Published online: 1 December 2008




J. Trig Brown, MD, MPH
George W. Divine, PhD
Gayle R. Fleming, RPh
William C. Siegal, MD, MPH
Moise A. Khayrallah, MA
From Duke University Medical Center, Durham, North Carolina; and the School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. For current author addresses, see end of text.

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Linda M. Frazier, J. Trig Brown, George W. Divine, et al. Can Physician Education Lower the Cost of Prescription Drugs?: A Prospective, Controlled Trial. Ann Intern Med.1991;115:116-121. doi:10.7326/0003-4819-115-2-116

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