Talking Money with Your Doctor: Drugs and Tests
for Less
By: Gary Cordingley
Would you buy groceries without knowing their prices? I suspect not. You
probably compare the costs of different boxes of cereal in order to get the
best deal. But when it comes to medical care, do you even ask for the prices
involved?
While it's true that good health is priceless, and cutting
corners on health care is risky, there is still much you can do in order to
obtain the same good value in medical care that you insist upon in other
areas of your life.
If you lack a prescription plan that pays for
your medications, it's high time you discussed the cost of drugs with your
doctor. Your doctor's number-one choice in medication for your medical
condition might be expensive. There are usually reasonable alternatives that
cost less. You should take advantage of your doctor's expertise in
estimating trade-offs involved with each of your options.
Apart from
prices, your doctor is already balancing a number of important factors in
making a drug recommendation. First, of course, the drug needs to be
medically effective—otherwise, why bother? The doctor also takes into
consideration what other medications you are taking, what other illnesses
you have, your age, your gender, the drug's side-effect spectrum, and also
its convenience aspects, like how many times per day it has to be taken and
whether or not blood-tests are required to monitor it. A drug that might
score high on effectiveness and side-effects might still be inconvenient. An
alterative might be both convenient and effective, but pose a higher risk of
side-effects.
So the truth of the matter is that your doctor is
already sorting through all sorts of trade-offs in choosing a medication to
prescribe. Factoring in the prices of alternative drugs just builds on the
comparing-apples-to-oranges process you are paying your doctor to do for you
in the first place. But if the doctor doesn't know that you lack a
prescription plan, he or she might not include the cost of drugs in these
reckonings and you might be stuck with a prescription that wrecks your
budget.
The next step in obtaining maximum value for your investment
in medication is to shop it around. Let your fingers do the walking by
phoning several pharmacies for a price-check. I even write out a script for
my shy patients who get nervous when they talk to medical personnel. It goes
something like this: "Hi, I'd like to do a price-check on my prescription
medication. How much would it cost to buy thirty furosemide 20 milligram (or
whatever) pills? Thank you very much. Have a great day!"
In repeating
this process with different pharmacies you will discover there can be quite
a spread among even nearby drugstores. Suppose that your ten minutes on the
phone saves you $20 on your prescription. Then you have just earned money at
a rate of $120 per hour each month for your efforts. It is time well
spent.
Cost-consciousness is also valuable when it comes to medical
tests. If the cost of a medical test is prohibitive (as is often the case)
and you don't have the luxury of letting someone else pay for it, then
encourage your doctor to talk through your alternatives with you. Does the
same test cost less at one facility than at another? How important is the
test? What could go wrong if you skip it, delay it or substitute a less
expensive test? What are the chances of a serious repercussion?
Unfortunately, your doctor usually has less latitude when cost-optimizing
your medical tests, but what could it hurt to ask? You might be glad you
did.
And how about optimizing the doctor's fee? This is also a fair
topic for discussion. When you are considering an appointment with a new
doctor it is certainly appropriate to ask for typical fees. However, in the
current U.S. medical marketplace, the doctor's time is usually the least
expensive component of medical care. The doctor's fee is usually much less
than the costs of medications and tests. So while it is perfectly reasonable
to shop around for affordable doctor fees, when it comes to choosing a
doctor, quality issues should come first.
(C) 2005 by Gary Cordingley
About the Author
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher
who works in Athens, Ohio. For more health-related articles see his website at:
http://www.cordingleyneurology.com
