Monday, November 18, 2013

Generic Prescribing and Conflicts of Interest

The great investigative reporting team at ProPublica did a good job on money wasted in Medicare through failing to prescribe generic drugs:
http://www.propublica.org/article/medicare-wastes-billions-on-name-brand-drugs

Now, the price of drugs, and generic prescribing, is not a hot topic on this blog, so the main thing I wanted to point out is one fact from the article. The authors note that a relatively small number of Medicare prescribers are responsible for a hugely disproportionate excess of brand-name prescriptions and hence unnecessarily high costs. They then  proceeded to check out their Dollars for Docs tool and noted that these same docs also seemed disproportionately represented among those receiving payments from drug companies. When ProPublica reporters visited some of the offices of these docs, they could hardly get in the door for all the drug reps waiting in line to handout free samples and other goodies.

As was nicely summarized in the excellent review article by Spurling and company from Healthy Skepticism:
http://brodyhooked.blogspot.com/2010/10/major-new-study-published-in-plos.html
--all the available evidence shows that taking money and information from the drug companies is associated with irrational prescribing and more expensive prescribing. I can think of few things more irrational than routinely prescribing brand-name drugs when a generic equivalent is available; and that certainly leads to higher costs.

2 comments:

Md Biplob said...

Yes your are wright and thanks for post a good topic . your post is

top most in related post of Hooked: Ethics, Medicine, and Pharma.

Anonymous said...

Marketplace Money podcast had a two minute segment on this ProPublica report. They went to Brooklyn to visit an NYU Medical Center where the prescribing of branded far exceeded, by 50%, the generic. The director of the center, a physician, said the reason was that patients did not trust generics to the point of thinking they could kill them.

Who is fooling whom?