When Do Doctors Consider a Patient’s Financial Situation When Prescribing Medication?

Prescribing medication based on a patient's financial situation is a complex and often critical factor in healthcare, especially in primary care and community health centers. When I was working as a primary care doctor, I always considered a patient's financial status. It is a widespread practice that goes beyond just the affordability of medications.

Complex Challenges in Medication Prescription

However, there are several challenges that complicate this practice:

Medication Shortages: Many medications, including older and inexpensive generic drugs, experience shortages. These shortages can affect medicines that were not prescribed by the doctor, such as chemotherapy drugs for cancer. Expensive Necessities: Some medications that are absolutely necessary for patients can be extremely expensive with no viable alternatives. For example, certain HIV treatments, including pre-exposure prophylaxis or PREP, can be unnecessarily costly.

Therefore, while doctors often consider a patient's financial situation, it is not always an easy task.

Stringent Financial Considerations for Patients of Modest Means

For patients with modest financial means, doctors may try to prescribe a less expensive alternative medication if it is nearly as effective and the condition being treated is minor. This decision depends on the availability and effectiveness of such alternatives.

Financial Assistance Programs and Generic Medications

Doctors and patients have access to financial assistance programs that can help pay for necessary medications. Here is an overview of how these programs work:

Identifying Financial Assistance Programs

There are financial assistance programs available through the manufacturer's website. The patient must go to the manufacturer's website and locate the link for the PATIENT ASSISTANCE PROGRAM LINK. From there, the patient can find an application that must be filled out by both the patient and their doctor.

Application Process

The patient should provide necessary information, such as their name, address, and income details. Once the patient has completed their portion of the application and answered the required questions, the form is given to the doctor for them to fill out the prescription information and sign an attestation that the patient needs the medication and meets the outlined requirements for assistance. The drug will be sent to the patient's home or the doctor’s office for pickup.

For ongoing treatment, the medication will be sent monthly to the patient or the doctor's office, typically at no cost or a low cost to the patient, as long as the generic drug is not available. The packaging of the medication will look like any other package the patient would receive, ensuring that the patient is not embarrassed or humiliated upon delivery.

Brand vs. Generic Medications

Many medications have a brand name given to them by the drug manufacturer, which is often easier to remember than the chemical name. For instance, while a commonly used drug for migraines is named Maxalt by the original manufacturer, Merck, the chemical name for Maxalt is Rizatriptan, which is almost identical. However, it is generally cheaper to buy and produce by other manufacturers who did not bear the advertising and marketing expenses incurred by the original manufacturer.

Conclusion

In conclusion, while doctors always consider a patient’s financial situation when prescribing medication, the process can be complicated due to medication shortages and the high costs of necessary treatments. Fortunately, there are financial assistance programs available that can help patients obtain the medications they need, provided they follow the application process properly.