5 ms·

They lost me at "might." You'd be hard-pressed to find many docs (myself included) who are champing at the bit to adopt an informational resource with knowledg

They lost me at "might." You'd be hard-pressed to find many docs (myself included) who are champing at the bit to adopt an informational resource with knowledge gaps.

jchw 7y ago
I don't understand. The article is about a pricing tool. The "might" is that it can't give useful price information for all kinds of insurance. It doesn't seem all that horrific that it might not be able to give useful pricing information for every single patient...?
- elliekelly 7y ago
  Doctors schedules are already tight as it is and I’m not sure what benefit there is to the doctor to spend the precious extra minutes looking to see whether they might be able to save their patients some money before prescribing a drug.
  - jchw 7y ago
    That is a different point to be made, and would apply even if the tool worked 100% of the time.
  - paganel 7y ago
    Because by saving the patient that sum of money said patient will maybe have enough funds to come visit said doctor for a second time (or a 3rd, or a 4th), instead of postponing the visit for financial reasons. In other words, if a doctor prescribes me a $1000 medicine instead of a $500 one, and a visit to said doctor costs $500, I might not visit him a second time because I've already paid $1000 for the medicine and I don't have enough money for my health anymore. Not visiting your doctor when you need it (for whatever reasons) is bad for the patient.
    - elliekelly 7y ago
      That’s not a very strong incentive. I’m not really sure that’s an incentive at all. Most doctors have more than enough appointments. Their schedules are overbooked. But even if doctors who needed more patient bookings could attract those bookings by saving patients money then logic would follow that doctors who have room in their schedule would consistently use the app from the article. Yet most doctors aren’t using it at all. So even if your premise is correct I think you’re greatly overestimating the surplus supply of doctors appointments and underestimating how steep/inelastic the demand curve is for healthcare. Mostly unrelated, is saying “surplus supply” redundant? I can’t decide.
- DataDrivenMD 7y ago
  The most valuable asset a doctor has is the trust of their patients. Not going to risk that for a half-baked product with lukewarm support from its developer and a weak endorsement from NPR. Even if this product could aggregate data from all the PBMs, that doesn't mean the drug will be in stock at a patient's local pharmacy. Furthermore, there are many commonly prescribed drugs that are cheaper to buy outright using a discount program (not insurance). Also, there are manufacturer-to-patient rebates offered for some brand name drugs without a generic. In short, there's a lot more information that doctors already factor into their decision-making process. This tool is not compelling enough to bring into the mix.
- stevekemp2 7y ago
  To me it seems insane that a doctor should care about the price of necessary medicines they're prescribing. If the insurance is available, and so good, then they should handle the payment stuff. A doctor should be learning about treatment, research and patients, not which company has the cheapest drugs this month.
  - khuey 7y ago
    For drugs that are new enough not to be available as generics, insurance companies typically have a "formulary" that specifies which drugs they will pay for and what the requirements are for them to pay for it. It might specify conditions like "we will only[0] cover drug Y from the class of drugs X" where drug Y is manufactured by AbbMerquibb and has negotiated a good price with the insurance company, or "we will only pay for drugs from class X after the cheaper frontline treatment Y has been tried and failed". Doctors prescribe specific drugs. They don't prescribe "whatever SLGT-2 inhibitor your insurance plan covers". They also don't prescribe "whatever your approved first-line therapy for rheumatoid arthritis is". If doctors prescribe without caring about the cost to their patients, the best case scenario is that those patients come back for another prescription after the pharmacy tells them that their drug will cost $$$$ because insurance is not covering it. The worst case scenario is that the patients don't come back and decide they can't afford to have their condition treated. [0] Barring patient intolerance to the preferred drug or various other exceptions.

They lost me at "might." You'd be hard-pressed to find many docs (myself included) who are champing at the bit to adopt an informational resource with knowledge gaps.

jchw 7y ago

I don't understand. The article is about a pricing tool. The "might" is that it can't give useful price information for all kinds of insurance. It doesn't seem all that horrific that it might not be able to give useful pricing information for every single patient...?

elliekelly 7y ago
Doctors schedules are already tight as it is and I’m not sure what benefit there is to the doctor to spend the precious extra minutes looking to see whether they might be able to save their patients some money before prescribing a drug.
- jchw 7y ago
  That is a different point to be made, and would apply even if the tool worked 100% of the time.
- paganel 7y ago
  Because by saving the patient that sum of money said patient will maybe have enough funds to come visit said doctor for a second time (or a 3rd, or a 4th), instead of postponing the visit for financial reasons. In other words, if a doctor prescribes me a $1000 medicine instead of a $500 one, and a visit to said doctor costs $500, I might not visit him a second time because I've already paid $1000 for the medicine and I don't have enough money for my health anymore. Not visiting your doctor when you need it (for whatever reasons) is bad for the patient.
  - elliekelly 7y ago
    That’s not a very strong incentive. I’m not really sure that’s an incentive at all. Most doctors have more than enough appointments. Their schedules are overbooked. But even if doctors who needed more patient bookings could attract those bookings by saving patients money then logic would follow that doctors who have room in their schedule would consistently use the app from the article. Yet most doctors aren’t using it at all. So even if your premise is correct I think you’re greatly overestimating the surplus supply of doctors appointments and underestimating how steep/inelastic the demand curve is for healthcare. Mostly unrelated, is saying “surplus supply” redundant? I can’t decide.
DataDrivenMD 7y ago
The most valuable asset a doctor has is the trust of their patients. Not going to risk that for a half-baked product with lukewarm support from its developer and a weak endorsement from NPR. Even if this product could aggregate data from all the PBMs, that doesn't mean the drug will be in stock at a patient's local pharmacy. Furthermore, there are many commonly prescribed drugs that are cheaper to buy outright using a discount program (not insurance). Also, there are manufacturer-to-patient rebates offered for some brand name drugs without a generic. In short, there's a lot more information that doctors already factor into their decision-making process. This tool is not compelling enough to bring into the mix.
stevekemp2 7y ago
To me it seems insane that a doctor should care about the price of necessary medicines they're prescribing. If the insurance is available, and so good, then they should handle the payment stuff. A doctor should be learning about treatment, research and patients, not which company has the cheapest drugs this month.
- khuey 7y ago
  For drugs that are new enough not to be available as generics, insurance companies typically have a "formulary" that specifies which drugs they will pay for and what the requirements are for them to pay for it. It might specify conditions like "we will only[0] cover drug Y from the class of drugs X" where drug Y is manufactured by AbbMerquibb and has negotiated a good price with the insurance company, or "we will only pay for drugs from class X after the cheaper frontline treatment Y has been tried and failed". Doctors prescribe specific drugs. They don't prescribe "whatever SLGT-2 inhibitor your insurance plan covers". They also don't prescribe "whatever your approved first-line therapy for rheumatoid arthritis is". If doctors prescribe without caring about the cost to their patients, the best case scenario is that those patients come back for another prescription after the pharmacy tells them that their drug will cost $$$$ because insurance is not covering it. The worst case scenario is that the patients don't come back and decide they can't afford to have their condition treated. [0] Barring patient intolerance to the preferred drug or various other exceptions.