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• W4220737768 abstract "We appreciate Falotico and Lipner’s response to our manuscript “Medicare Part D prescription trends in the use and cost of dermatology medications.” The authors provide valuable additional insight into the inverse relationship between dermatologic medication costs and prescription volume. We agree that the phenomenon may be explained in good part by dermatology providers’ knowledge of drug efficacy and the lack of price transparency. Dermatologists, dermatology residents, and dermatology providers (nurse practitioners and physician assistants) significantly underestimate the cost of common dermatologic medications, with an average absolute percent error of 52% to 60%.1Steen A.J. Mann J.A. Carlberg V.M. Kimball A.B. Musty M.J. Simpson E.L. Understanding the cost of dermatologic care: a survey study of dermatology providers, residents, and patients.J Am Acad Dermatol. 2017; 76: 609-617Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar In a study by Kassamali et al,2Kassamali B. Faletsky A. Han J.J. et al.Physician perspectives on the effect of topical steroid costs on patients and proposed solutions.JAMA Dermatol. 2022; 158: 79-83Crossref PubMed Scopus (2) Google Scholar 94% of physicians reported being unaware of medication costs before prescribing them. In fact, 75% of physicians acquired their knowledge of drug costs from patients during follow-up.2Kassamali B. Faletsky A. Han J.J. et al.Physician perspectives on the effect of topical steroid costs on patients and proposed solutions.JAMA Dermatol. 2022; 158: 79-83Crossref PubMed Scopus (2) Google Scholar Cost is also of great concern to patients. In a survey study, 84% of patients reported that knowing the out-of-pocket costs for medications was important or very important; however, <50% of patients received this information from their dermatology providers.1Steen A.J. Mann J.A. Carlberg V.M. Kimball A.B. Musty M.J. Simpson E.L. Understanding the cost of dermatologic care: a survey study of dermatology providers, residents, and patients.J Am Acad Dermatol. 2017; 76: 609-617Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar Additionally, >25% of patients reported not filling dermatologic prescriptions because of costs. A proposed solution is medication substitution at the point of sale. Unless a physician specifically indicates that substitutions are not allowed, a pharmacist would select the least expensive option for the patient within the same drug class.3Gupta S. Menge T. LaChance A. Mostaghimi A. The potential impact of same-class substitution of topical steroids on health care spending.J Am Acad Dermatol. 2020; 83: e439-e440Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar Without a systemic overhaul to ensure price transparency, however, the source of the problem will remain, and the discrepancies will persist. None disclosed. Balancing medication cost, safety, and efficacy among Medicare beneficiaries with dermatologic conditionsJournal of the American Academy of DermatologyVol. 87Issue 1PreviewWe appreciate the analysis of dermatology medication cost trends using Medicare Part D data, 2013-2019, by Hwang et al,1 which demonstrated that 60% of the 10 most prescribed medications decreased in price, with generally inverse relationships between medication cost and prescribing. In this letter, we corroborate the findings that increased drug and out-of-pocket costs may impact generic medication prescribing, with drug efficacy being more impactful for prescribing specialty medications, and highlight additional factors that drive dermatology prescription patterns. Full-Text PDF" @default.
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• W4220737768 date "2022-07-01" @default.
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• W4220737768 title "Response to Falotico and Lipner’s “Balancing medication cost, safety, and efficacy among Medicare beneficiaries with dermatologic conditions”" @default.
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• W4220737768 doi "https://doi.org/10.1016/j.jaad.2022.03.028" @default.
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