SURVEY ABOUT YOUR PRESCRIPTION CHOICES
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1 Editor s Note: This online data supplement contains supplemental material that was not included with the published article by William Shrank and colleagues, Patients' Perceptions of Generic Medications, Health Affairs 28, no. 2 (2009): Brigham and Women s Hospital and Express Scripts February 17, 2007 SURVEY ABOUT YOUR PRESCRIPTION CHOICES 1. Please read and answer every question. If you are unable to provide an exact answer, your best guess will do. 2. When you are finished with the survey, please place it in the enclosed self-addressed stamped envelope and place in any mailbox. Thank you very much for your time and attention.
2 YOUR GENERAL BELIEFS ABOUT GENERIC DRUGS 1. The following questions explore your beliefs about generic and brand name medications. To what extent do you agree or with the following statements? Disagree Disagree on each line a. I would rather take generic than brand name medications. b. Brand name drugs are more effective than generic drugs. c. Generic drugs are safer than brand name drugs. d. Generic drugs cause more side effects than brand name drugs. e. Generic drugs are less expensive than brand name drugs. f. Generic drugs are a better value than brand name drugs. g. Medications that have been on the market longer are safer than newer drugs. h. Newer medications are more effective than older medications. YOUR BELIEFS ABOUT PRESCRIPTION DRUG COSTS 2. The following statements refer to the overall costs of prescription drugs in the United States. To what extent do you agree or with each of the following statements? Disagree Disagree on each line a. Americans spend too much money on prescription drugs. b. Americans should use more generic drugs. c. The government should create rules to increase generic drug use in Medicare. d. Health care insurance companies should create rules to increase generic drug use. e. Private insurers should require patients to try generic drugs first, and only use brand name drugs if the generics are not effective. f. The government should require Medicare patients to try generic drugs first, and switch to brand name drugs if the generics are not effective. g. The cost of prescription drugs is too high. Survey About Prescription Choices Page 1
3 PRESCRIBING CHOICES FOR SPECIFIC DRUGS 3. For the next set of questions, assume your doctor just told you that you have high cholesterol and need treatment. You will likely need to take a medication for your cholesterol every day for years. To what extent do you agree with the following statements? When treating my high cholesterol. Disagree Disagree on each line a. I would rather take a generic drug than a brand name drug. b. A brand name drug would be more effective than a generic drug. c. A generic drug would cause worse side effects than a brand name drug. d. A generic drug would be less expensive than a brand name drug. e. A generic drug would be a better value than a brand name drug. 4. For the next set of questions, assume you have severe back pain and your doctor has prescribed a medication to treat your pain. You will likely need to take a medication for your back pain every day for two weeks. To what extent do you agree with the following statements? When treating my back pain. Disagree Disagree on each line a. I would rather take a generic drug than a brand name drug. b. A brand name drug would be more effective than a generic drug. c. A generic drug would cause worse side effects than a brand name drug. d. A generic drug would be less expensive than a brand name drug. e. A generic drug would be a better value than a brand name drug. Survey About Prescription Choices Page 2
4 PRESCRIBING CHOICES FOR SPECIFIC DRUGS 5. Please indicate how often the following occurs when you receive a new prescription from your doctor or fill a prescription at the pharmacy: Never Seldom Some of the time on each line Most of the time All of the time a. I ask my doctor if a generic option is available. b. I ask my pharmacist if a generic option is available. c. My doctor talks to me about generic medications. d. My pharmacist talks to me about generic medications To what extent do you agree with the following statements? Disagree Disagree on each line a. I feel comfortable asking my doctor to substitute a generic form of a brand name medication. b. I feel comfortable asking my pharmacist to substitute a generic form of a brand name medication. c. I don t mind when my pharmacist switches my prescription to a generic medication. YOUR MEDICATION USE 7. In the last year, did you not fill or refill a medication because it was too expensive? Yes 7 No 7a. If yes, how many prescriptions in the last year did you not fill or refill because it was too expensive? (Please fill in your best guess at the number of prescriptions) Survey About Prescription Choices Page 3
5 WHAT WOULD YOU CHOOSE? 8. Here are a few questions about how you would make decisions about cholesterol medications. Assume that your doctor has prescribed a medication to treat your high cholesterol. You have to decide whether you want to buy a brand name or a generic drug to treat your cholesterol. It is likely that you will need to take this medication for years. Which of the following are true: 8a. I would buy the generic only if it were less expensive for me than the branded drug. True 9 False (If you answered false skip question 8b and go to 8c) 8b. How much would you have to save each month for you to choose the generic over the branded drug? 0 $1 less 1 $2-3 less 12 $4-5 less 13 $6-10 less 14 $11-15 less 15 $16-20 less 16 $21-30 less 17 $31-40 less 18 $41-50 less 19 >$50 less for each line. 8c. I would never buy the generic drug. True False 8d. I would take the generic drug if it were free. True False 9. We would like to ask you questions about how you would choose your medication if you needed a drug to treat back pain. Your doctor advises you to take the medication for two weeks. You have to decide whether you want to buy a branded pain medication or a generic drug. 9a. I would only buy the generic if it were less expensive for me than the branded drug. 0 True 21 False (If you answered false skip question 9b and go to 9c) 9b. How much do you have to save each month for you to choose the generic over the branded drug? 2 $1 less 3 $2-3 less 24 $4-5 less 25 $6-10 less 26 $11-15 less 27 $16-20 less 28 $21-30 less 29 $31-40 less 30 $41-50 less 31 >$50 less for each line. 9c. I would never buy the generic drug. True False 9d. I would take the generic drug if it were free. True False 10. Here are some questions about how you would choose your medication if you needed treatment for depression. Let s say that there is both a brand name drug and a generic drug to treat your condition. It is likely that you will need to take this medication for months or even years. Which of the following are true: 10a. I would only buy the generic if it were less expensive for me than the branded drug. 2 True 33 False (If you answered false skip question 10b and go to 10c) Survey About Prescription Choices Page 4
6 10b. How much would you have to save each month for you to choose the generic over the branded drug? 4 $1 less 5 $2-3 less 36 $4-5 less 37 $6-10 less 38 $11-15 less 39 $16-20 less 40 $21-30 less 41 $31-40 less 42 $41-50 less 43 >$50 less for each line. 10c. I would never buy the generic drug. True False 10d. I would take the generic drug if it were free. True False 11. To what extent do you agree or with each of the following statements? Disagree Disagree on each line a. I am confident that my doctor prescribes the least expensive medication for me. b. It is my responsibility to learn about generic drugs and drug costs to make sure I receive the least expensive medication. c. I know where to go to find information on generic drugs and drug costs. 12. If you wanted to learn more about generic drug options and drug costs, who would you ask? (Please list your top three choices) 1) 2) 3) 13. If you wanted to look up information about generic drug options and drug costs, where would you look? (Please list your top three choices, and please be specific) 1) 2) 3) Survey About Prescription Choices Page 5
7 SOME QUESTIONS ABOUT YOU 14. In general, would you describe your health as: Check the best answer 0 Excellent 1 Very good 2 Good 3 Fair 4 Poor 15. Please describe your level of education: High school or less Some college 2 College graduate 3 Graduate school 16. Please describe your race or ethnicity: African American 2 Asian/Pacific Islander Hispanic 3 Caucasian/White 4 Other Please describe your gender: Male 1 Female 18. Please estimate your total household income in 2006: < $15,000 $15-30,000 2 $30-50,000 3 $50-75,000 4 $75-100,000 5 >$100,000 Survey About Prescription Choices Page 6
8 Thank you for completing this survey! Survey About Prescription Choices Page 7
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