A generic-switching incentive program is coming under fire. Costs are clearly cut when patients are switched generic medications:
An HMO owned by Blue Cross Blue Shield of Michigan ran one such program and the insurer says it made $2 million in payments to docs but saved $5 million in drug costs. Patients saved $1 million on lower co-payments for the generics.
You can talk about professionalism all you want, but the reality is that physicians really only respond to financial incentives.
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In a word, no. If there is a sound medical reason to switch a patient to a generic, or even an OTC drug, then that should suffice. Equal efficacy at lower cost without unacceptable risk of side effects is a sound medical reason. Bribery is not.
“You can talk about professionalism all you want, but the reality is that physicians really only respond to financial incentives.”
Not a sound interpretation Kevin.
1) They did save their patient’s money too. Would you have condemned the docs if they had steadfastly refuse to allow their patient’s this savings.
2) You conclude that docs ‘only’ respond to financial incentives, when there is no evidence to support this. While it is probable that they did respond to financial incentive, no evidence is available to conclude that nothing else would have moved them.
3) If docs respond to financial incentives, and it is not contrary to patient interest (nowhere in the story is it supported that patient interest was compromised), then it merely means that docs are indeed still human and respond to their environment, financial and otherwise.
The only caveat in all this is to remember that everyone, regardless of their intentions, will be swayed to some extent at some degree of incentive/pressure. It is appropriate to keep light upon insurer policies such as this to ensure that incentive programs do not become so strong oor counter to patient interest that the inevitable harm does occur. The business side of medicine knows business and how to manipulate people to get what it wants; its principal tool is money and what it wants is money.
Funny…
The insurance company has a financial incentive to switch, and no one has a problem with that.
The patient has a financial incentive to switch, and no one questions it.
However, the doctors are given a financial incentive, and all of a sudden it’s unethical.
My office is completely bogged down with scrip refill requests due to formulary changes, prior auths, etc; these time consuming efforts should absolutely be compensated.
Underpaid in Upstate New York
Some doctors are motivated primarily by financial incentives—most have other values at stake as well. And as professionalism is defined by an ethic of putting the patients first, I would say that the doctors who respond only to financial incentives are really physicians at all, license notwithstanding.
Same goes with the high cost of implants. If there is no financial incentive, I don’t care I’m putting in the Mercedes everytime when a Chevy will do. Why would I do anything otherwise. Is it unethical to put the absolute best in every patient, damn the costs. Or is it more ethical to save the hospital administrator’s bottom line. If you want to encourage behavior you have to pay for it plan and simple.
I don’t know whether this is ethical or not, but it’s not illegal.
Nevertheless, if its ok to pay docs to switch to generics, it should be ok for drug companies to pay doctors to switch back!
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