Why do some doctors prescribe a newer medicine which is still under patent

[raccoon]

as opposed to a generic? What's in it for the doctor?

Sometimes the newer med might be better for some people than the generic, but I doubt if that's true for everyone.

[Spider Jerusalem]

1. Free golf trips paid for by the pharmaceutical co rep.

Among other things.

[blondeatlast]

12. Yep, but if I ask my docs, they will prescribe non-patents unless

the patent is clearly superior (as one of mine is).

[Craftsman]

2. My old doctor used to have drug reps there alot, he got some good freebee's

this is why he is my old doctor.

[raccoon]

3. Reason I asked is my sister's doctor wants to put her on Lipitor, which is still under patent.

I suggested to her that maybe there might be a generic she could take. If indeed she needs to be on it in the first place. She's already taking beaucoup meds.

She is covered by husband's insurance, but I don't know anything about their co-pays, etc.

[Spider Jerusalem]

5. Then you may find this of interest:

http://www.bloomberg.com/apps/news?pid=20601124&sid=a.bEyUqNtvJE

[raccoon]

7. Thank you! I emailed sister that link. nt

[HopeHoops]

4. Kick backs! They should be illegal.

[JohnnyLib2]

6. Some docs keep a close eye on the literature and do their best.

Those who do are aware of new meds being developed and where they stand in the approval process. The same is true with some meds which are in regular use in other countries. An astute physician (or one with university ties) may know what is coming before the pharmacy reps show up.

This may not be true of all M.D.s and it's damned hard to know about that. I just want to put a word in for the good ones!

[Bitwit1234]

8. Well in some cases the ones not generic

are covered by some prescriptions and not as expensive. If you can't afford the regular price, ask the doctor to give you a generic, they will. Sometimes they give you the free samples the drug reps gave them. My doctor gives me the packets sometimes. I used t have my Nexium approved by the prescription provider and he would give me the packets till approval arrived.

[MineralMan]

9. The answer is that the patient has to suggest the idea.

The doctor isn't paying for the meds; the patient is.

Of course, the drug manufacturers want to sell their latest drug. In many cases, it's no better than the older generic, but they need to make money, above all.

When your doctor pulls out the prescription pad, ask if there's a generic substitute he's about to prescribe. Very often, he/she will say "Sure. I'll write a prescription for xxx. It's always worked well for this condition."

If you don't ask, you don't get.

[timeforpeace]

15. Actually, the insurance is.

[stray cat]

10. If you are on long term medication - you should not vary manufacturers

the generic are made by different companies and your pharmacy may not get use the same source for it each time you go in. If you accidently switch to a different manufacturer because its all listed as generic you are suppose to get your blood work repeated to make sure the dose in your system is still the same.

[timeforpeace]

14. Not true. Plus the chemical entity is exactly the same, source makes no difference. Big Pharma

claims stuff like this though.

[Fire_Medic_Dave]

20. Actually there can be significant differences in doses of generic meds.

Walgreens switched to a different manufacturer of a certain medication I am on, it stopped being effective to the point I was going to quit taking it. My doctor told me to find a different pharmacy that sold the other brand and the medication started working again. She said that there can be as much as 25% difference in the certain amounts of different ingredients between manufacturers.

[revolution breeze]

24. Not to mention binders

I have autoimmune disease as well as other associated health problems. I am able to take the brand name of one of the long term "maintenance" medications used to prevent progression, but the generic causes severe side effects. My pharmacist advised he had seen this before as different binding agents were used in the brand name vs. the generic. I took this information to my doctor, which he verified with another Rheumatologist, but my insurance company still denied me the brand name.

[calico1]

27. This is true.

They are not exactly alike as the brand name despite what some people claim or believe. In a lot of cases it doesn't matter but sometimes it makes a big difference.

[ProgressiveProfessor]

11. Sometimes it is just the best fit

Not every drug has a generic alternative.

The Pharma reps have been really cut back on what they can give etc. A good thing in my opinion

[MercutioATC]

13. Exactly.

Nexium works 100% for me. Nothing else does.

[meow2u3]

16. Kickbacks from the drug companies

Kickbacks from pharmaceutical companies, euphemistically called "rebates", are the primary reason some docs prescribe the patented meds you see in prescription drug commercials.

Instead of asking your doctor about (insert prescription medicine here), you should ask your doctor why he's prescribing the heavily-advertised meds instead of the good, old ones that work.

[Sgent]

18. Show me

that is a wild accusation that would constitute fraud if it happened. If you have knowledge of doctor's directly receiving payments from a drug manufacturer for prescribing their drug, I suggest you call your local US Attorney's office and turn them in.

Doctor's do get some things from drug manufacturers -- mostly "speaking fees". Years ago they used to get "scholarships" to various conferences that took place in various remote Caribbean locals. Today doctors at most usually get a free dinner or free lunch for them and their staff. Even the pens are no longer free. These are not usually based on prescription volume but rather on being a certain specialty (all cardiologists, internal medicine, and family medicine doctors welcome to a dinner regarding statin's for example). Spouses are now forbidden at the dinners unless they are in the medical field (nurse, doctor, etc).

[Fire_Medic_Dave]

17. Do you have an example?

[FDRLincoln]

19. It Depends

It depends.

I take lipitor and it has done a wondrous job lowering my cholesterol from dangerous levels (375) to very good (150) while improving the HDL/LDL profile greatly. I took zocor for awhile, but it was not as effective. Zocor also impacted my liver enzymes negatively while lipitor did not.

Nevertheless, I'm considering switching back to generic zocor. Even with insurance, lipitor costs me over $100 a month. Our finances are precarious right now and I can't afford the lipitor much longer unless something changes financially. I told my doctor, and he went ahead and gave me a generic zocor script that I can fill if I want to. I'll stick things out on lipitor for another month or two, but will switch back to zocor if worse comes to worst with the money situation.

So in my case at least, lipitor IS better than zocor and my doctor gave me the proper drug, no kickbacks or corruption involved. However, everyone's body is different. Some people would probably do better on zocor, and for many people there would be no difference at all.

[billyclem]

21. I see the anti-MD faction of DU is alive and well.

Their view of the average doctor is living in a massive home with a 4 bay garage filled with $75K+ vehicles, doing all they can to wring every last cent from their patients no matter how. Guess what, doctors like that are an extremely small minority. The rest are hard working individuals who actually care about their patients. I don't know what kind of experiences the anti-doctor types have had, perhaps I have just been lucky.

I am 61, my doc is a few years younger and I was one of his first patients when he set up in private practice. He is far from a money grubbing status accumulator, donating a lot of his time on weekends and evenings to free clinics and an AIDS clinic. The youngest of his 4 adopted kids has just started college and he finally traded in his 13yr old Subaru for a lavish Ford Focus. His wife drives a 7yr old minivan.

As a doctor he prescribes a new medicine if he feels it is appropriate for the patient; otherwise, generic.

[raccoon]

23. Gosh, you sure read a lot between the lines! nt

[fishnfla]

22. Sometimes the generic is harmful

the dyes and fillers in a generic med can cause reactions

[revolution breeze]

25. Exactly!

When I had a reaction to the generic of one medication after taking the brand name for several month, my insurance still denied me the brand name even with documentation from my physician. The rep for my insurance company said 'Why don't you ask him to prescribe XYZ, I hear that is used for treating your condition and we will pay for that." Excuse me, I don't want some insurance company deciding my course of treatment!

[DefenseLawyer]

26. I had a friend several years ago who quit his job as a corporate lawyer

because he could make more money as much as a pharmaceutical rep. When you make a pill for a penny and sell it for $300, you tend to have quite a bit of money to throw around.