Canadian doctors don't know costs of prescribed treatments

For the most part, family physicians in British Columbia aren't even close when they guess the costs of the treatments and tests they prescribe for their patients, according to a new study published in the journal Canadian Family Physician.

Seventy-three per cent of the doctors surveyed could not estimate the costs of their orders to patients within 25 per cent of the actual costs. And not only do they not know the costs, in many cases they are "wild" in their guessing, says Dr. Michael Allan, a professor in the U of A Department of Family Medicine and a co-author of the study. The research involved analyzing the survey responses of 259 doctors in British Columbia.

In particular, doctors underestimated the costs of lab tests. The major cost of a single laboratory test is the one time cost of phlebotomy--the act of drawing blood--and the Primary Base (up front) fees.

Thus, it may be less expensive to order all anticipated tests in a group so that you only pay the phlebotomy and Primary Base fees once rather doing what is commonly taught in medical schools, which is to order one or a few tests and then order more tests based on those results. In the latter case you would have to pay the Primary Base fee every time new tests are ordered, Allan said, adding that further research is needed to identify if either approach is superior in cost saving or patient outcomes.

"But we do know that small ticket items like laboratory tests are high volume and a large expense to health care," he added.

According to the study, doctors also underestimate the costs of expensive drugs while overestimating the cost of inexpensive drug, demonstrating they have little understanding of the often dramatic difference between the two. Without understanding the significant difference between the price of some drugs, physicians may be more easily swayed by the pharmaceutical industry to prescribe more expensive drugs, ev

Contact: Ryan Smith
University of Alberta

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