Tuesday, May 26, 2009

Generics a Bargain? Maybe Not.

This article proves to be a distressing read, particularly for those of us who use generic prescription medication on a daily basis. Indeed, many of us are locked firmly into relying on generics because even the best insurance plans often insist upon covering them rather than the much pricier name brands. My regular readers have noted that when the cost of medication per bottle or per unit without insurance is obscenely high in general, lower cost alternatives are a godsend. Though it should be noted that not every medication with a generic equivalent should be considered suspect, this is enough of a problem that it might be good sense to do one's homework from henceforth.

For bare-bone insurance plans like Medicaid or Medicare, many times the only way name brand medications are covered at all are unless the doctor insists upon prescribing a name-brand or if no generic alternative is currently available. And as I have dealt with myself, just being handed a prescription is often no guarantee of coverage. Medicaid, in particular, tries to save as much money as it can by bullying doctors into prescribing lower cost alternatives so that the General Fund from which all medical expenses are drawn from is not depleted. This is tantamount to a medical system informing doctors that their discretion is better and if I were a licensed practitioner, I might take serious offense to it. The only way that Medicaid agrees to cover certain flagged drugs is when additional paperwork is filled out and sent in, specifying that the exact medication prescribed is the most effective treatment and that lower cost alternatives have been tried before and have not worked.

Still, the matter does cut both ways. Many doctors receive gifts and money from pharmaceutical companies, which certainly influences their choice of prescription, even if that medication might be more expensive for the consumer than another one. As the above article point out, with prohibitively expensive prescription drugs and in keeping with a global economy, more and more industry has been outsourced to the third world and so perhaps it was inevitable that pharmaceutical manufacturing would head the same way. Regrettably, the American consumer's hands are tied in the matter. Unlike insisting upon buying American or making a conscious choice to buy environmentally friendly products in a store, the cost differential between name brand drugs and generic equivalents is vast, and cannot be compared to paying a few dollars more for organic laundry detergent or produce. Furthermore, as noted above, with the insurance companies taking their roles as an inescapable middle man, one has no choice but to play by their rules and jump through their hoops.

When one compares the matter to the past, one thinks of the historical precedent for FDA regulation and approval of medication, which was the 1906 Pure Food and Drug Act. This reform measure eventually established the Food and Drug Administration though it was designed specifically to combat quack and patent medications which were frequently marketed as cure-alls to combat a variety of illnesses, but were often comprised overwhelmingly of alcohol, cocaine or morphine. What is needed now is a new set of regulations and firm parameters that must be adhered to for the safety of the consumer. When regulation is whittled away to suit the aims of business, the health and safety of everyone inevitably suffers mightily.


Life As I Know It Now said...

That last sentence summed it up nicely. Great post!

Anonymous said...

I saw this story on the local news, and instantly suspected some video PR from the pharmaceutical industry. It's nice to have a more substantial source. The article does not give a sense of the size of the problem, though, as it relies entirely on anecdotes, not statistics. I'm sure it's true that FDA dropped the ball on investigating generic drug makers during the Bush years, but I question whether any policy changes are really called for, besides having FDA once again do what it's supposed to. I also wonder how SELF magazine funded this long-term investigation. The article didn't make that clear, although to its credit it did point out at one point the funding that some doctors' groups get from drug companies — which might be a factor in their expressed concern about generics.