Lack of insurance coverage was a concern for 10 patients (38%), and high out-of-pocket costs were a concern for 11 patients (42%), the authors reported. Additionally, 5 participants (19%) said they had received inconsistent information from physicians, physician’s office staff, and pharmacy staff about the prior authorization process.
Participants reported having discussions with providers about treatment side effects and instructions for use – but not about price concerns. In addition, patients “did not expect physicians to know medication cost or insurance coverage,” the authors said. The patients also described various approaches recommended by providers to address problems obtaining medication, including asking patients to call the office back (7%), shopping around for medication (7%), suggesting alternatives to first-line treatment (7%), and offering coupons (4%). Backup plans (offered when the medication was not available) were received positively by 23% of the patients, as was a candid conversation about cost (19%), whereas shopping around and calling the office back were not, the authors said.
Overall, 10 patients (38%) reported reservations about treatment, which included concerns about possible adverse effects (15%), unwillingness to start a “strong” medication (8%), desire to try homeopathic treatment (3%), and belief that their acne was not serious enough to require medication (12%).
The results suggest that “physician-level interventions to improve primary adherence should incorporate discussion of medication costs and provide specific alternative plans in case the patient is unable to fill the prescription, rather than asking patients to call back,” the authors wrote. “Physicians who discuss medication costs and provide a concrete alternative plan may be able to improve primary adherence among their patients,” they concluded.