Can physician education lower the cost of prescription drugs? A prospective, controlled trial

Ann Intern Med. 1991 Jul 15;115(2):116-21. doi: 10.7326/0003-4819-115-2-116.


Objective: To determine whether an educational program featuring a drug cost manual can assist physicians in reducing their patients' out-of-pocket prescription drug expenses.

Design: Prospective controlled trial.

Setting: A general internal medicine-teaching clinic in a university hospital.

Participants: Fifty-one medical interns.

Intervention: Thirty-one interns received a manual of comparative drug prices annotated with prescribing advice, two feedback reports, and weekly cost-oriented prescribing reminders. A control group concurrently participated in a manual-based educational program on cholesterol management.

Measurements: Copies of 3012 prescriptions written over 8 months were analyzed.

Main results: Intervention group physicians prescribed less expensive drugs within classes of drugs. The change in drug price score per prescription was -0.15 (95% Cl, -0.27 to -0.04; P = 0.01). A score of 3 was assigned to the most expensive, 2 was assigned to intermediate-priced, and 1 was assigned to the least expensive drug or drugs in the class. An increase of 0.74 months' (Cl, 0.49 to 0.98; P less than 0.001) supply of medication was dispensed per prescription, reducing dispensing fees. The program was well accepted by the physicians.

Conclusion: This relatively simple educational intervention can help physicians to reduce their patients' drug expenses and may serve as a model for incorporating cost information into the routine practice of medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost Control / methods
  • Drug Prescriptions / economics*
  • Education, Medical*
  • Educational Measurement
  • Health Knowledge, Attitudes, Practice
  • Internship and Residency
  • Manuals as Topic
  • North Carolina
  • Outpatient Clinics, Hospital / economics
  • Program Evaluation / methods
  • Prospective Studies