- Dermatologists are more likely to prescribe expensive creams than primary care
- A study found that dermatologist creams were $13 to $14 more expensive
- In 2014, a study found the doctors were pocketing money from drug companies
Has your skin been itching lately? Unless you want to spend a lot of money, you may want to skip a trip to the dermatologist.
Patients looking to pay less for prescription skin creams and ointments for inflammatory conditions - like psoriasis - may be best served by their primary care doctor instead, a new study suggests.
This is because dermatologists and other specialists are three times more likely than primary care providers to prescribe brand name versions of drugs.
A 30-day supply of brand prescriptions for patients averaged about $174 more for total costs and roughly $27 more in average out-of-pocket costs than generic alternatives, researchers found.
Dermatologists are three times more likely than primary care doctors to prescribe expensive, brand name versions of creams and ointments, a new study claims
The study, conducted at Ohio University Medical Center, examined prescription data for people with Medicare Part D drug benefits in 2008 and 2010. Costs from 2008 were adjusted for inflation to 2010 prices.
Researchers also analyzed prescriptions from doctors in specialty fields including dermatology, family medicine, internal medicine, psychiatry and neurology.
Regardless of medication potency, prescriptions generally cost more when patients saw dermatologists than when they received care from other physicians, the study found.
WHAT IS PSORIASIS?
Psoriasis is a skin condition that causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful.
It can appear anywhere, but shows up most often on your scalp, elbows, knees, and lower back.
The cause of psoriasis isn't fully known, but it's thought to be related to an immune system problem with cells in your body.
You cannot 'catch' psoriasis by touching someone who has the condition.
Signs and Symptoms:
- Red patches of skin covered with silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Psoriasis is a life-long condition for which there is no cure.
Used alone, creams and ointments that you apply to your skin can effectively treat mild to moderate psoriasis.
When the disease is more severe, creams are likely to be combined with oral medications or light therapy.
- Vitamin D analogues - it slows down the growth of skin cells
- Anthralin - this medication is believed to normalize DNA activity in skin cells
- Topical retinoids - like other vitamin A derivatives, it normalizes DNA activity in skin cells
For patients, the total cost for a 30-day prescription from a dermatologist was $13 to $14 higher than a prescription from a physician in family or internal medicine, and $23 more than one from a specialist in psychiatry or neurology.
In comparison to doctors in family or internal medicine, dermatologists prescribed drugs with a yearly cost of $30 million to $32 million.
This suggests that there's potential to save up to about 11 percent on total costs using prescriptions from non-specialist doctors, the researchers concluded.
'We would assume dermatologists are treating more extensive diseases and thus requiring higher volumes of topical treatments, but this was not available in the database,' said senior author Dr Benjamin Kaffenberger, of Ohio State University Medical Center in Columbus.
'This data is not linked to outcomes or diagnoses. It is possible that outcomes may justify the additional costs in this study.
'For example, if they get the right treatment that works for them and they don't need return visits.'
Not all brand name remedies have generic alternatives on the market.
But generic treatments can work just as well for the vast majority of patients, said Dr Aaron Kesselheim, a researcher at Brigham and Women's Hospital and Harvard University in Boston who wasn't involved in the study.
He said: 'Patients should make sure to ask their physicians about whether there is a less expensive generic drug that is indicated for their conditions.
'Cost-related non-adherence is unfortunately too common among patients, and substitution of an equally effective generic drug for a brand name drug is a simple way to improve patient adherence and clinical outcomes.'
In 2014, a study found that nearly three-quarters of US dermatologists received payments worth a collective $34 million from drug companies.
While in most cases, the payments were worth less than $50, there were a few doctors were taking industry payments worth at least $93,622.
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