October 24, 2016 Is Your Physician’s Loyalty Costing You Extra Money? Kate Thorn Amid skyrocketing prescription costs, and despite studies demonstrating equal efficacy between brand name drugs and their generic counterparts, many physicians still opt to prescribe more expensive branded therapies for their patients. Between 2010 and 2012 patients spent about $24.6 billion more than they needed to in out of pocket costs for prescriptions for branded drugs instead of the equivalent generic. An investigation, published in JAMA Internal Medicine, determined that certain drug classes – including statins, atypical antipsychotics, proton pump inhibitors, selective serotonin reuptake inhibitors and angiotensin receptor blockers – accounted for the majority or overall excess branded spending. “There was a large amount of excess expenditure on branded drugs between 2010 and 2012 in classes that could have incorporated therapeutic substitution,” the authors concluded in that study. “Although therapeutic substitution is controversial, it offers a mechanism to decrease drug costs if it can be implemented in a way that does not negatively affect quality of care.” Dr. Manish Bansal, a pharmacist, has noticed this trend within his own practice. He notes that patients have often asked him why their physician is prescribing them brand name medications when a perfectly viable generic alternative exists. “The Pharma and Medical Device industry have figured out for decades now that developing a partnership with the Physician can be lucrative and provide high level peer-to-peer market development,” he posits. “There are thousands of physicians that are “Promotional Speakers/Faculty” for these companies. When a physician is a promotional speaker for these companies they are required to deliver a promotional program to their peers usually at a dinner program within the scope of guidelines set by the company. The company then engages with that physician and via a conduit gets introduced to their same specialty peers.”
In fact, a separate analysis published in JAMA Internal Medicine found that physicians that enjoyed industry-sponsored meals appeared to be more likely to prescribe the band-name drug that was being promoted at such a sponsored event. Pharmacists should empower patients with information regarding their medication options and encourage them to ask their physicians about their financial relationships with pharmaceutical companies. “Patients should ask their doctor: Are you a promotional speaker for a company? Are you prescribing any medications you are a promotional speaker for in my personal care?” Dr. Bansal advises. “Patients have a right to know especially when there may be a cheaper alternative available in the market.” More transparency and greater accountability for physicians and their branded drug prescribing habits can add benefits to the already successful generic drug model. As
it stands, generic drugs comprise nearly 90% of all prescriptions filled in US pharmacies. To date, they have provided nearly $1.7 trillion in health care savings over the past 10 years.