Here and Now

This Toronto physician says doctors should be required to know the price of drugs

Canadian physicians are largely unaware of the cost of the drugs that they prescribing to their patients, says a Toronto family physician who is pushing for legislation that would require doctors to know drug prices.

High drug costs are cited as a main reason why prescriptions go unfilled

Dr. Iris Gorfinkel is a Toronto based family physician and clinical researcher (PrimeHealth Family Practice)

Canadian physicians are largely unaware of the cost of the drugs they prescribe to their patients, and Dr. Iris Gorfinkel, a Toronto family physician and founder of The PrimeHealth Clinical Research site, is pushing for legislation that will require doctors to know drug prices.

"If you buy a pair of slacks, or if I buy a shirt, I'm going to have to know how much they cost. Why should that be different for something as big as a drug that we are going to have to continually pay for?" said Gorfinkel on CBC Toronto's Here And Now Friday.

Several research studies show that doctors know extremely little about drug prices, according to Dr. Joel Lexchin, an emergency room physician and a University of Toronto professor.

Teaching medication costs is not part of the current medical school curriculum. (Shutterstock)

Lexchin says his lack of knowledge can result in a doctor prescribing a brand of drug that is more expensive than its generic version, even though both medications do exactly the same thing.

Since high drug costs were cited as the main reason for one third of prescriptions not being filled in a Canadian Institutes of Health Research study, Gorfinkel believes patients need to know their options before they even leave the clinic.

It's usually not until patients go to the pharmacy to fill out their prescription that they discover how much they are expected to shell out, says Gorfinkel. 

"There is a problem when someone is standing at the pharmacy holding their breath," says Gorfinkel. "That is the moment I want to focus on; the moment someone has to choose between rent and medicine."

Forced to care

Doctors have the ability to access information concerning drug costs through various databases and resources. So why are they not keeping themselves informed?

It's not unusual for physicians to see dozens of patients in a day and with all of their medical duties, physicians don't have the time to research every single drug option for each individual, Gorfinkel told Here And Now.

Dr. Steve Morgan, professor of health policy at the University of British Columbia, says there is also evidence that some doctors just don't care.

"Cost of drugs does not affect their practice," says Morgan. "Sometimes the doctors may even get paid by the drug companies to become an opinion leader."

Drug companies add to the problem by making it confusing for doctors to locate and compare prices, according to Gorfinkel.

"They don't want consumers to know. They want to make money," she said.

Gorfinkel has proposed that the provincial government mandates that drug prices be added to the electronic medical records (EMRs) that 83 per cent of Ontario MD's are already using.

Patients often have no idea how much a drug costs until they talk to their pharmacist. Many cite cost as a reason their prescriptions go unfilled. (Radio-Canada)

Her vision is that along with the patient's medical history and information about the drugs side effects, an extra line would be added to a person's record comparing different prices for prescribed medication. Doctors would be required to inform themselves of the cost through this digital tool.

She says if enough people start demanding to know comparable drug costs, then the government will be forced to add the information to EMRs.

"Doctors have a moral responsibility and patients have the right to know what drug-care options they have," said Gorfinkel.

"Less expensive can be just as valuable."

With files from Here and Now