A Cross-Sectional Study to Evaluate the Awareness and Attitudes of Physicians Towards Reducing the Cost of Prescription Drugs, Mumbai

Abstract

In India, about half of the total health expenditure is spent on medicines. The projected increase in various diseases coupled with the skyrocketing drug prices have further compounded the drug cost burden. We conducted a study to assess the awareness, attitudes, and practices of physicians with regard to various cost containment measures and the factors affecting them. A cross-sectional, questionnaire-based, observational study was conducted over a period of 3 months among 200 physicians, after permission from the Institutional Ethics Committee, at the Grant Medical College and Sir J J Group of Hospitals, Mumbai. The STROBE (Strengthening The Reporting of OBservational studies in Epidemiology) guidelines were followed. Cost considerations were important to 97% of government doctors (GDs) and 72% of private doctors (PDs). Eighty percent of both GDs and PDs said that safety and efficacy were more important than cost. Seventy-one percent of GDs and 65% of PDs knew about the various cost reduction methods. Twenty-four percent of GDs and 65% of PDs said that they graded drugs according to cost. Ninety-four percent of GDs and 73% of PDs said that patent protection should not be extended to life-saving drugs. Sixty-four percent of GDs and 10% of PDs, and 20% of GDs and 10% of PDs were in favor of the stepwise introduction of drugs and the use of generics, respectively. Factors precluding the use of cheaper alternatives were narrow therapeutic index drugs (43.5%) and fear of substandard quality (38.5%). Doctors are indeed concerned about the high cost of drugs. More awareness needs to be created about the use of cheaper generics. The government has a very important role to play in reducing the cost of prescription drugs and making healthcare affordable.