As a recently retired physician who worked in family practice, palliative care, and occupational medicine for more than 30 years, I read “Is it time to drug test your chronic pain patient?” (J Fam Pract. 2010;59:628-633) with interest. I myself suffer from arthritis in the neck and low back, for which a medical school colleague prescribed a very low dose of hydrocodone prn several years ago. I believe my resident physician may have read your article right before my last office visit; he suggested a drug screen was appropriate for me because hydrocodone is a “high-risk” medication.
I understood, of course, and readily agreed. After all, I did thousands of these screens during my years of practice—at a cost of about $5 per test. The authors of your article apparently did not research the average retail cost of the test, stating only that it is “inexpensive.” Imagine my surprise when I saw the bill—$676 for the drug screen alone. My insurer readily paid its portion of the “allowable” charge ($434).
The medication itself is wonderful; it helps keep me functioning and costs me about 8 cents per pill, so I won’t complain too much. But I suspect that most of your readers would be surprised by the true cost of this “inexpensive” test at a major medical school.
Mack Tyner, MD