---
title: "Psych News Alert: Doctors, MDD Patients Found to Have Different Cost Concerns"
description: Health care costs appear to be a regular topic of conversation between psychiatrists and patients receiving care for major depressive dis...
image: https://alert.psychnews.org/hubfs/Imported_Blog_Media/doctor_patient_therapist_iStock-541117484-Jun-24-2025-04-47-37-0184-PM.jpg
---

 3/16/17 12:00 AM

# Doctors, MDD Patients Found to Have Different Cost Concerns

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Health care costs appear to be a regular topic of conversation between psychiatrists and patients receiving care for major depressive disorder (MDD), occurring in more than one in three visits, according to a [study](http://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201600275) published today in *Psychiatric Services in Advance*. The study found psychiatrists may be more likely to initiate a conversation about the cost of psychotropic medications, while patients may be more likely to initiate a dialogue about the cost of provider visits.

Gregory Brown, M.D., of Duke University School of Medicine and colleagues relied on content of patient visits sampled from the Verilogue Point-of-Practice database of audio-recorded and transcribed clinical encounters. The researchers focused specifically on visits for medication management in outpatient, private-practice offices across the United States. The researchers considered any mention of a patient’s out-of-pocket expenses or insurance coverage for a past, present, or potential health care service to be a “cost conversation.”

A total of 422 patients with MDD and 36 psychiatrists in clinics across 20 states were included in the study. The researchers found that 38% of visits contained a cost conversation. Cost conversations most commonly addressed medications (n=136 of 208; 65% of all cost conversation topics), and more than half of these conversations dealt specifically with the cost of psychotropic drugs (n=107 of 208; 51%). Nonpharmacologic therapies and services accounted for 35% of cost-conversation topics.

Although rates for initiating cost conversations were similar between psychiatrists and patients, physicians were more likely to initiate conversations about the cost of psychotropic medications than patients (62% versus 38%). In contrast, patients were more likely to initiate conversations about the cost of provider visits (27% versus 10%).

Overall, 45% of cost conversations involved at least one cost-reduction strategy, such as facilitating the use of copay-assistance programs or cost-saving coupons, providing free samples, or switching to a lower-cost therapy or diagnostic test.

“By exploring the frequency and duration of discussions about health care cost in these encounters, as well as the cost-reducing strategies therein, we are able to provide novel insights about the extent to which psychiatrists and patients discuss efforts to manage out-of-pocket health care costs,” wrote Brown and colleagues. “[W]e hope to help psychiatrists recognize the many ways in which they can help patients reduce out-of-pocket expenses.”

For related information, see the *Psychiatric News* article “[Levin Meets With Congressional Leaders About Fate of Affordable Care Act](http://psychnews.psychiatryonline.org/doi/full/10.1176/appi.pn.2017.3b6).”

(Image: iStock/sturti)

---

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[depression](https://alert.psychnews.org/tag/depression), [health care costs](https://alert.psychnews.org/tag/health-care-costs), [shared decision making](https://alert.psychnews.org/tag/shared-decision-making)

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