Prescribers’ knowledge of drug costs: a contemporary Irish study

Previous research has suggested that prescribers’ knowledge of drug costs in Ireland is deficient. We aimed to update this finding by asking prescribers to estimate drug costs for low-and high-cost drugs, as well as examining their familiarity with a national prescribing initiative. We conducted a survey of five groups of prescribers and one group of medical students asking them to estimate the drug costs. Drugs recommended by the Preferred Drugs Initiative in Ireland were included, as were high-cost monoclonal antibody products and nutrition supplements. A 25% margin of error was allowed for a correct estimate. Comparisons were performed across participant groups and between drugs. A number of qualitative questions were included to provide context. The survey received 122 responses. General practitioners (GPs) had the most accurate estimates, with medical students having the least. The percentage with a correct estimate was lower for higher cost drugs across all participant groups. GPs were also most certain about the estimates and most familiar with the Preferred Drug Initiative, while the students rated worst for both these questions. The cost of most drugs was overestimated. Most prescribers were uncertain about their estimates, which was reflected by the large variation in estimates. Eighty-three percent of prescribers would consider a trade-off of drug efficacy for affordability at least sometimes. Prescribers’ knowledge of drug costs in Ireland remains poor and may negatively affect patient outcomes and national drug budgets. A national program provides recommendations to improve cost-effective prescribing; however, further alterations to national prescribing practices and policies are required to raise awareness of drug costs and these recommendations.