Rx choices: Who decides patients, physicians or health care providers?
Nov/03/2007 08:01 Filed in: DTC
Environment
I take Lipitor everyday and recently when I went to refill my Rx I noticed that the copay had gone up from $7.00 to $20.00 The pharmacy tech informed me that the difference in copay was due to the fact that I chose to use the branded (lipitor) over the generic (simvastatin). Now I have taken Lipitor for over three years and have manageable side effects and great results in lower blood cholesterol. I had tried simvastatin a long time ago but found that it gave me leg pain and cramps. I therefor have decided to stay with Lipitor. When I asked my physician about this he said that the has received a lot of correspondence from insurers suggesting that patients be moved to the generic statin to as it is "just as effective" as branded alternatives.
According to today's New York Times:
Each month, doctors with patients on Lipitor are switching tens of thousands of them to simvastatin. And simvastatin is also taking a growing share of the market for new patients who need a cholesterol drug. “Simvastatin is much less expensive to society over all and to patients,” said Dr. Thomas H. Lee Jr., a prominent cardiologist. “If you put patients on generics,” he said, “the chances that they’re taking their medications six months later are higher than on a brand name drug. I think that a few hundred dollars a year does matter
So even though a patient does his or her research and has health insurance they may not get the brand they ask for when going they go to their physician. Is a way to save money in the patients best interests? Do insurers have the right to charge more money for branded products? This is a question that is going to have to be answered by the patients but if the sales decline of Lipitor is any indication than this trend will continue and pharma will have to make major adjustments to their pricing models.
What I don't like about health providers getting into the mix is that the decision is based too much on economics and not the patients health. Pfizer has done a lot of clinical studies around Lipitor clearly showing its benefits. There are no such comparative studies for simvastatin, only raw data about the decline in cholesterol of the patient. Chrysler, the once mighty auto giant, will not let physicians write prescriptions for Nexium unless the patient has tried OTC Prilosec. They feel this could save tens of millions of dollars annually.
This is a dangerous trend as it take the pen out of physicians hand and puts it in the hands of the pharmacy director. He can make a name for himself if he recommends to management that generics are just as good as branded alternatives and could save the company millions of dollars. Pharma has to do a lot better job of differentiation when marketing branded products with generic equivalents. If they don't start now, with the patient, then all the DTC could be for nought.
|