Wednesday, August 05, 2009

The pharmaceutical industry and American health care

Today I sat in our family doctor's waiting room for three hours while my husband was seen for broken ribs. While we were there (and waiting for three hours), a total of eight different drug company representatives were allowed welcomed in to speak to our family doctor. Eight.

The numbers today may have been a little unusual, but the presence of drug representatives is not. I have yet to come to see my physician with out spotting at least one and more often two or three drug representatives during the time of my visit.

Why be concerned? Well first, why with people waiting for hours in the lobby, should drug reps be given the fast track to doctors time? But far more importantly, how much pressure is being brought to bear on family physicians and internists to prescribe new, more costly, patented medicines instead of older, less expensive, generic medicines?

More than a decade ago, after some type of injury my physician prescribed a generic muscle relaxant for me. It worked well, was helpful, and cost me (with health insurance) $5. A year or so later, after another injury, she prescribed a new brand new, name brand muscle relaxant, that when I got to the pharmacy turned out to cost $45 (with insurance -- imagine what it would have cost without insurance). Well it didn't work as well for me as the generic. Some time later, another injury, another visit, and time for another prescription. This time I specifically told her that I wanted the generic, that I found it worked better than the name brand and was 1/9th the cost. She mumbled a bit and said, oh, well I was told that this new medicine would be better, and wouldn't upset people's stomachs. While this may be true, it never once occurred to my doctor to 1) ask if I'd had any problems with the generic drug and needed a substitution or 2) think about the huge difference in cost. This kind of blind acceptance of drug company sales pitches is part of the current problem with health care.