Noncompliance: The Price We Pay for High-Cost Treatment

Daniel Meltzer, MD

Written by Daniel Meltzer, MD

Q: Should we be discussing cost with our patients and if so, how?

A: Costs, medication costs in particular, are often cited by patients as their primary hurdles to treatment adherence. And we also know that medication-related issues including noncompliance are primary drivers of hospital readmissions. So we can begin to see that at some level, the system, if not the treating clinician (where, theoretically, “the buck stops”), has to address and be mindful of cost when caring for and communicating with patients.

Nevertheless, we know that all of us caring for patients are stretched with time and competing priorities. Therefore, this notion of cost management in addition to disease management is best dealt with systemwide. For the treating clinician at the bedside, there are some things we can do to improve shared decision making and compliance in light of medications and their costs.

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