{'fraction_non_alphanumeric': 0.01970802919708029, 'fraction_numerical': 0.009732360097323601, 'mean_word_length': 5.3052147239263805, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Physician customer satisfaction and medication assistance programs from pharmaceutical companies.

According to the US Census Bureau, in 2006 approximately 15.8% (47 million) of Americans did not have health insurance—many because of financial constraints. Consequently, these people also cannot afford the cost of the medications necessary to treat their illnesses. Pharmaceutical medication assistance programs (MAPs) constitute one method of help for individuals who cannot afford the cost of medications; MAPs provide the necessary medications at reduced, minimal, or no cost to the patient consumer. In this issue of the SMJ, Pisu et al studied attitudes of physicians toward the MAPs provided by pharmaceutical companies. Pisu et al’s results showed that 70% of physicians regularly use such programs, and 73.2% of these regular users indicated that these programs were very helpful. With an apparent high endorsement among regular physician users, it seems that pharmaceutical companies should be proud of the success of these MAPs. However, Pisu et al also provide data about barriers for use, including the fact that 54.7% of the physicians reported that the enrollment process was timeconsuming for office staff. Also, 45.9% reported the inability of patients to directly apply. Only 11.3% reported no barriers. This feedback does not appear exactly complimentary or indicate a high level of satisfaction among consumers. Apparently, physicians are still participating because they care for their patients and are willing to deal with some of these barriers. Will physicians continue to participate, especially if they believe that the enrollment process is too time-consuming for their office staff? Physicians in the United States are increasingly experiencing a lot of pressure to provide service to more patients, and it is possible that with this challenge, the noncompensated work associated with facilitating MAPs for patients may be neglected or even discontinued. One study attempted to understand the actual cost experienced by physicians for the time that their office staff took to process applications for pharmaceutical MAPs. Costs per application for one patient ranged from $7.73 to $58.13, with an average cost of $25.18 for the 32 companies studied. There were additional costs related to medication distribution as well. A commentary on that study indicated that these costs were quite conservative and could be even much higher than what was calculated. There is only so much that physicians can do before the barriers associated with processing medication assistance programs become too burdensome. It is also important to keep in mind that there are already physicians who do not bother with initiating the process for pharmaceutical MAPs. A review published in 2002 mentioned a number of barriers and challenges that both patients and health care providers face when applying for MAPs. This review recommended a “universal” application process to help simplify and expedite the process. One can understand the hesitation of pharmaceutical companies for not enthusiastically endorsing such an approach, as this would involve working with their competition. Some question remains about the true motive for pharmaceutical company MAPs. It has been suggested that these programs are not philanthropic, but rather are a marketing ploy to promote brand-name medications at the expense of generic alternatives. In a different vein, it has also been suggested that patient consumers prefer brandname medications due to the perceived risks of using generic medication alternatives. Regardless of the pharmaceutical companies’ reasons for their endorsement of MAPs, what can they do to make this a more efficacious process for physicians? Pharmaceutical companies should make a strong effort to make their processes more “user friendly” so that physicians will endorse and utilize these assistance programs. A new, revised approach from pharmaceutical companies can help them partner with physicians to provide appropriate treatment to all patients, regardless of their financial status.