Who is to blame for expensive medications, the Doctor?

It is the perspective of the patient, when given brand prescriptions from his or her doctor, to blame the doctor.  “Oh, she’s too expensive,” some might say.  People know there are plenty of generic drugs out there, which certainly could curb their medical bills.  Why don’t doctors prescribe them instead?  Are they bowing down instead to the pharmaceutical industry?

If you see a doctor over a long period of time, he might be reluctant to try a generic drug, if one exists, as the Brand pill has been doing good for you the way it is.  “Why change it?  You’re ahead of the pack.”  Also, he may be writing out these prescriptions for drugs for a long time and feels safe in prescribing the Brands.  And he writes a prescription for the expensive drug over and over again.  It almost becomes a habit.  Your doctor is getting older and probably thinks he’s seen it all.  Has he been keeping up with the pharmaceutical industry?

The patient may fear switching to a generic drug for the same reason.  He’s afraid his symptoms will come back and doesn’t trust the generic drug.  He wants to stay on the Brand drug, even though his doctor thinks the generic is just as good.  The patient has read in Reader’s Digest or somewhere that “generic drugs aren't put together well.  They don’t have the polymers necessary to do justice to the pill.”  The doctor writes out a prescription for the expensive drug and probably takes note of how his patient finds it effective and writes it out again for other patients; particularly new ones who don’t read  tabloids.

The pharmaceutical industry send their impeccably dressed sales people to visit the doctor; to explain new drugs and hammer home the drugs’ worthiness, which she’ll think of when a patient comes in with a particular set of symptoms.  Some doctors try out the new medications, but the older doctors may continue to use the same ones he’s been using, which his patients find helpful.  But if she sees many patients, the doctor might prescribe the same brand or generic medication she’s used forever.  Some doctors would want to wait and see how the new drug does in the population.  If there’s something bad about the drug, she doesn’t use it, e.g., Celebrex disappeared from the market.  It was a powerful anti- inflammatory drug, but heavy users developed ulcers.  (This is true regarding aspirin, but it’s still out there.)

Companies that develop generics cannot spend as much money on advertising or marketing.  They try to get the doctors to try the cheaper substitutes.  And there are hundreds of drug companies trying to win his attention, when he has many patients.  The doctor does not have the time to listen to a generic pharmaceutical argument or a more advanced drug company.

Education of the public about generic, inexpensive drugs might provide the solution.  If they learn that there is an inexpensive form of the drug they take, they will urge the doctor to write them a prescription for this inexpensive drug.  Making a total revolt of the system wouldn’t be wise.  To only allow drug companies to sell generics would turn us upside down.  The pharmaceutical companies would do well to turn their attention on the patients and the public, about the cheaper form of the Brand drug.  And, if necessary, see if the pharmacist can help you.

Posted By Dr.Malpani

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