Publication:

Impact of patient’s socioeconomic status on drug prescribing decisions among physicians: a qualitative analysis

Background A qualitative descriptive study was conducted among 50 physicians from public and private healthcare sectors using purposive sampling. Data was collected through semi-structured, open-ended interviews to explore physician’s views on how patient socioeconomic status (SES) influences prescribing patterns. Responses were analyzed thematically to identify key determinants and strategies used by physician’s to address socioeconomic disparities.

Methods A qualitative descriptive study was conducted among 50 physicians from public and private healthcare sectors using purposive sampling. Data was collected through semi-structured, open-ended interviews to explore physician’s views on how patient SES influences prescribing patterns. Responses were analyzed thematically to identify key determinants and strategies used by physician’s to address socioeconomic disparities.

Results Physicians widely acknowledged SES as a major determinant of prescribing decisions with affordability influencing drug selection, dosage and treatment duration especially in chronic and elective care. Common adaptive strategies included prescribing cost-effective regimens, providing free samples, and referring patients to government schemes such as Jan Aushadhi and NPCBVI. While most physicians recognized the affordability benefits of generic drugs, scepticism regarding their bioavailability and clinical efficacy persisted. Ethical and emotional strain was evident, particularly when physicians had to balance optimal therapy with patients’ financial constraints. Emergency and critical care prescribing remained largely SES neutral.

Conclusions Patient’s SES significantly shapes prescribing decisions in non-emergency contexts. Enhancing access to affordable medicines, strengthening trust in generics through regulatory oversight, and integrating pharmacoeconomic and socioeconomic sensitivity training into medical education are essential to promote equitable, patient-centered prescribing practices.