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Killer Cure

Elizabeth L. Bewley's Blog About Health Care

June 18, 2010

Do Initiatives to Pay You for Taking Drugs Take Risks of Side Effects into Account?

Filed under: Friday's You Must Be Kidding, Paying You — admin @ 1:00 am
Health care professionals often lament that people don’t take drugs as prescribed.  One article notes, “One-third to one-half of all patients do not take medication as prescribed, and up to one-quarter never fill prescriptions at all, experts say.  Such lapses fuel more than $100 billion dollars in health costs annually because those patients often get sicker.”   (Pam Belluck, “For Forgetful, Cask Helps the Medicine Go Down,” New York Times, 13 June 2010.) What’s not clear, though, is how those dollar savings  are calculated.  Eight to ten million people a year land in the hospital due to side effects of the medicine they take.   (See my 18 May 2010 blog entry.)  Are estimated costs of treating side effects subtracted from the estimated cost savings for treating the original condition?  It’s not immediately clear that the initiatives to pay people for taking drugs are taking into account the risks people assume by taking them.

June 17, 2010

Unintended Consequences: Paying You to Take Meds

Filed under: Paying You, Thursday's Quick Quiz — admin @ 1:00 am
Which of the following are likely to be unintended consequences of paying people to take drugs prescribed for them when they haven't taken them when prescribed in the past?










June 16, 2010

Is It Coercive To Pay You to Take Medicine?

Filed under: Paying You, Wednesday's Quote — admin @ 1:00 am

“Skeptics question if payments [to patients for taking drugs prescribed for them] can be coercive or harm doctor-patient relationships.”  From “For Forgetful, Cash Helps the Medicine Go Down,” by Pam Belluck, New York Times, 13 June 2010.  Treating people like lab rats who are rewarded with food pellets for pressing a lever — making treatment decisions be about immediate rewards rather than about benefits and risks of treatments — has some disquieting implications.

June 15, 2010

Don’t Let Offers of Cash Derail Common Sense

Filed under: Paying You, Tuesday's Tips — admin @ 1:00 am

If you are offered financial incentives to take medicine that you’re expected to take for a long time, remember to ask three lifesaving questions:  “How will we know if this drug is working for me?”  “When will we know if this drug is working for me?”  and “What problems should I be watching out for?” 

The typical drug helps only about half the people who take it, and side effects of drugs put 8-10 million people a year in the hospital.  See Killer Cure, Chapter Four “The Patient as Footnote” and Chapter Five, “The Mushroom Treatment” for more information.

June 14, 2010

Paying People to Take Their Meds — Does It Work?

Filed under: Monday's Myth or Fact, Paying You — admin @ 1:00 am

Myth or fact:  offering money to people to take their medicine succeeds in getting them to take it. 

Fact:  In the short run, paying people to take their medicine gets them to take it.  However, in the long run, at least one study shows that once they are no longer paid, they stop taking the medicine.  In other words, taking medicine comes to be about the money, not about benefiting their health.   See “For Forgetful, Cash Helps the Medicine Go Down,” by Pam Belluck, New York Times, 13 June 2010.

Paying You To Take Your Meds

Filed under: Overview of Week's Theme, Paying You — admin @ 12:59 am

If you aren’t taking the medicine your doctor has prescribed, would paying you $20-$90/month get you to take it?  This week’s blog explores the implications of programs that pay people to take their medicine.  See “For Forgetful, Cash Helps the Medicine Go Down,” by Pam Belluck, New York Times, 13 June 2010.

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