Doctors Paid to Prescribe Generic Drugs

Generic_prescriptions
Health insurers have provided doctors with financial incentives to prescribe generic medications
, according to an article in yesterday’s Wall Street Journal:

Health plans are drawing scrutiny for offering financial incentives to entice doctors to prescribe cheaper generic medicines, including paying doctors $100 each time they switch a patient from a brand-name drug.

Pharmaceutical companies have long gone to great lengths to try to get doctors to prescribe their brand-name pills. They spend billions of dollars, plying physicians with samples, educational lunches and speaker fees. But as the patents for a growing number of blockbuster medicines expire, some health insurers are trying to trump those perks with bonuses or higher reimbursements for writing more generic prescriptions.

The idea, health plans say, is to save everyone — patients, employers and insurers — money. And many doctors argue that it’s only right to reimburse them for spending time evaluating whether a cheaper generic alternative is better or as good for a patient.

Thanks to Dr. Christina Peterson of Migraine Survival for the heads up

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2 Responses to “Doctors Paid to Prescribe Generic Drugs”

  1. Migraineur Says:

    Well, this is a tough one. In general, I am not happy to be given the latest, most expensive drug just because my doc has recently been visited by a salesperson. I’d rather start with an older drug, for two reasons – they are cheaper, and they have been in use long enough that things like side effects are well understood and well documented. New drugs are expensive, and the FDA requires only minimal testing, so I am not convinced that any new drug is all that safe. Think Vioxx, Avandia, and Baycol. Furthermore, I’m taking an older, relatively safe drug (Inderal, which was approved over 40 years ago), and it works great for me. I’m glad I tried it.

    On the other hand, I think doctors should have the freedom to prescribe the newer, more expensive drugs if the older ones fail. Using the same example, Inderal doesn’t work for everyone, and I hope that this policy wouldn’t prevent a doctor from trying something else.

  2. ChristinaP Says:

    On the other hand…drugs like amitriptyline are presumed to be safe, because they have been in use for so long. They have not been tested at all for migraine by the FDA.

    This, however, is the greater concern: do you want your doctor to be paid $100 to switch you from, say, Maxalt or Frova or Zomig, which works for you, to Fioricet because it is a generic medication? Or Imitrex, when it goes generic?

    I just read an article today (the research was done in Europe) indicating that responsivity to anti-depressants is genetically determined, and that individuals should be tested to see which medication they might respond to, particularly if they are not responding to therapy. Regence Blue Cross already has a policy of requiring a that a generic SSRI be prescribed first. This precludes my choice of the most effective preventative in this class. Generic sertraline, paroxetine, or fluoxetine are just not as effective as Effexor or Remeron.

    There are already policies in place to discourage the prescription of “something else”. In fact, quite a bit of pressure is exerted. This is just further leverage on the part of the insurance industry to control physicians.

    What disturbs me the most is the ethics of this practice. Insurance companies are not doctors. They should not be permitted to practice medicine, and they most certainly should not be permitted to allow the bottom line to influence care decisions in the absence of clinical criteria.

    This is a bribe, and it tempts utter corruption–and it does so far more blatantly than lunch from a pharmaceutical company does.


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