Nov 15, 2007 11:13 pm US/Central
Should Doctors Get Paid For Prescribing Generics?
(WCCO)
For 25 years, Rob Chapman has been a painter and for some of those years he's struggled with high cholesterol.
"My doctor and I decided it was time for me to go on a cholesterol medication," he said.
After suffering side effects from several generic drugs, things were looking grim. That's until his doctor prescribed Crestor.
"I tolerate it. It keeps my cholesterol at an acceptable level. I'm really happy with it," said Chapman.
Crestor is a brand name drug, and while there are other drugs to treat high cholesterol, there is no generic equivalent. For many patients like Chapman, generics drugs don't work as well.
Sometimes doctors prescribe generics because they're cheaper. However, the topic of debate at an upcoming medical ethics committee meeting is whether generics are being prescribed for another reason.
"Primary care doctors, I have been told, are expected to prescribe a certain number, percentage of generics, whether that's in the best interest of the patient, or not," said Dr. Gary Hanovich, a cardiologist.
The practice is known as "pay for performance." HMOs like Medica and HealthPartners give doctors money if the number of generic prescriptions they write reaches a target percentage.
Hanovich said he's concerned about the pressure the program creates for all doctors.
"Making a generic substitution to save the health plan money has no benefit to the patient's health," said Hanovich.
The Minnesota Council of Health Plans, which represents HMOs, said pay for performance is for transparency in health care. They believe as long as the [generic] drugs are equivalent, pay for performance is a reasonable measure and a legitimate cost-saving technique.
However, that's not enough to convince Chapman.
"Should I be asking my doctor when I get a prescription, 'Why are you prescribing this particular one?' And maybe directly asking him, 'Are you receiving any money?'" he said.
For those who want to voice their opinion on the issue, the Ramsey Medical Society Council on Professionalism and Ethics, along with the medical staffs of United and HealthEast Hospitals, are sponsoring a public meeting on Friday about this topic.
The meeting will be held at United Hospital's John Nasseff Medical Center at 225 North Smith Avenue in St. Paul from 7:30 to 8:30 a.m.
(© MMVIII, CBS Broadcasting Inc. All Rights Reserved.)
