Brand-Name Drugs Cost Medicare Billions
Doctors with ties to industry go with pricey versions instead of generics
By John Johnson, Newser Staff
Posted Nov 19, 2013 12:16 PM CST

(Newser) – So much money wasted, such a seemingly simple fix. A ProPublica investigation finds that a relatively small group of doctors costs taxpayers hundreds of millions dollars per year because they choose to prescribe pricey brand-name drugs to low-income Medicare patients instead of generic versions. Is it because they have hearts of gold and believe the brand-name versions will be better for their patients, despite evidence to the contrary? Maybe. Or it could be because "many of these physicians also have accepted thousands of dollars in promotional or consulting fees from drug companies," according to the story. The total lost to over-prescribing is well into the billions over eight years.

One big problem is that Medicare, unlike the Department of Veterans Affairs and lots of private insurance plans, has no rules in place that limit doctors in prescribing brand-name drugs. One physician alone in Los Angeles could have saved Medicare $5 million in 2011 had he prescribed the way his peers did; said doctor also just happened to rake in $7,000 in speaking fees and meals from Big Pharma. Click for the full story, or for a previous one suggesting lax oversight of the Medicare Part D program.

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Nov 21, 2013 1:03 PM CST
Which medicine do you think ObamaCare will pay for and push; generic or brand name? Hint, it's called the AFFORDABLE Care Act.. hmmm Are generics the same, or do they have the same affect as brand name drugs?. No, they are not. They cannot be the same due to patent laws. Do they work for your specific problem? Maybe.. Maybe not. Now since every action has an equal and opposite reaction what could be the downside of using ONLY generics? Big Pharma employs hundreds of doctors & chemists, spends millions of dollars and takes dozens of years testing, developing and marketing a product for a specific medical issue. After 5 years of government testing they may finally getting FDA approval and they can put the product on the market and charge $ 20 a pill, thinking that in about 5-8 years they will recover all their investment and then make a nice profit. Sleezy RX buys Big Pharmas product as soon as it hits the market and reverse engineers it with similar, but not the same, ingredients. They have one year of development, a fraction of the testing and a faster FDA approval (after all it's copied after something that was tested for five years). They do no marketing or advertising, they do not spend the money calling on doctors, hospitals or pharmacies, instead relying solely on cheaper price. Now is Big Pharma going to continue to spend money and time developing new products when every time it does it is ripped off by a similar, cheaper, less tested, generic?? Not for long. They have to recover their cost and investment to survice. They have to charge more for their product to remain profitable and in business - unless their employees, suppliers and creditors are willing to accept "generic" (instead of real) dollars for payment.
Nov 20, 2013 10:37 AM CST
These doctors receive very pricy trips and perks from the med companies for NOT allowing the use of a generic. Also, is it just me but I've received two bills from the emergency room recently. If using insurance the bill is ten times as high. If not, it is much lower. What's up with that?
Nov 20, 2013 7:43 AM CST
Generics are often the best deal, but in some cases there are actual formulation differences that can be problematical. I know a person who must take thyroid replacement and this individual has found that the generic doesn't keep hormone levels even, while the name brand does. This was learned by experimentation. On the other hand, I must use an eye drop for mild glaucoma and have found that that the expensive drop, at $75 for a tiny vial, is no more effective than the $7 generic version which my pharmacist recommended. My doctor was reluctant, but agreed to the experiment. He was pleasantly surprised, but expressed some dismay that he'd been mislead by the drug reps who'd visited his office and who told him the new generic version was no good.