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E-DRUG: Money magazine on drug promotion (fwd)
---------- Forwarded message ----------
Date: Thu, 15 May 1997 06:39:59 -0400
Subject: E-DRUG: Money magazine on drug promotion
E-drug: Money magazine on drug promotion
Thought this maybe of interest to fellow E-druggers.
Syed Rizwanuddin Ahmad
Wednesday, May 14, 1997
Drugmakers pressuring medical pros to prescribe their
Money investigation finds sound medicine may take back
seat to bottom lines
by Ira Hellman
Major drug companies routinely pressure doctors,
pharmacists and insurers to push, restrict or even switch
prescriptions to benefit the companies' financial health,
and in some instances, Money magazine reports in its June
issue, the practice has even harmed patients.
A three-month Money investigation reveals that
drugmakers and bureaucratic middlemen called pharmacy
benefit managers are increasingly using discounts,
rebates and other pressures and inducements to wrest
control of prescriptions from the medical professionals
on whom patients have relied for generations. The
business stakes are high, reports Money writer Peter
Keating: Consumers and their insurers spent $78 billion in
the U.S. last year to fill 2.5 million separate
prescriptions. Yet, if anything, the human stakes are
Money relates chilling stories of patients forced to
suffer, or to pay stiff out-of-pocket expenses, because
drugs their doctors had prescribed were not on their
insurers' "approved" lists. Moreover, it notes that
switching prescriptions can increase patients' risk of
getting medications that may not work best for them.
Indeed, Dr. Philip Alper, a Burlingame, Calif. internist and
one of the few doctors who would speak with the
magazine on the record, calls the practice "massive,
underfunded human experimentation." Among Money's
* When managed-care plans decide which drugs they will
pay for, one of the first factors they consider is which
drugmaker offers the best rebate program. Virtually all
managed-care plans maintain lists of approved drugs
called formularies, allowing patients to buy certain drugs
cheaply at selected pharmacies. Trouble is, these once-
extensive lists are being whittled down--in one case, to
only 89 medications--by drugmakers who strike deals
with pharmacy benefit managers (PBMs). Drug companies
often offer rebates or discounts to get PBMs and
managed-care plans to push particular products. In other
cases, they have simply bought PBMs, which ironically
were created to help lower prescription costs--and did so
prior to the '90s. In fact, since 1993, drugmakers have
acquired the nation's three largest PBMs, at a total cost
of $12.9 billion. Money notes that most HMOs and PBMs
insist that they make sure their lists include a broad
range of medications.
* Drug companies exert pressure on doctors and
pharmacists to change your prescriptions. Pharmacists
and doctors are regularly bombarded will letters, calls
and faxes--many including offers of cash payments--
urging them to stop prescribing certain medications in
favor of others. Some of the approaches are routine
marketing ploys, Money reports. But others are over the
top. "I get phone calls asking me to switch my patients'
prescriptions about 10 or 12 times every day," says Dr.
Giacomo Buscaino, a Brooklyn cardiologist. "I've been
asked to switch specific patients to drugs that haven't
been proved to have the effects they need. I've been asked
to switch patients to drugs that were more expensive
than the ones they were on already."
* Drugs are being switched even when there is no evidence
that the change is always safe for patients--or cheaper.
Medical experts, including the American Medical
Association, are overwhelmingly opposed to restrictive
drug lists and to marketing programs that reward health
professionals for substituting one prescription for
another. Moreover, recent research indicates that reducing
access to prescription drugs could actually increase
overall long-term health-care costs. The reason: Patients
who don't get the prescriptions they need end up using
more drugs and going to doctors and hospitals more
Money details ways prescription patients can get what
they need. Among the tips: Ask your insurer for a copy of
the procedures you would have to follow to request
reimbursement for drugs that are not covered. Question
any changes in your drugs. And support public policies that
will promote health, not profits, as the primary objective
of prescription benefit programs.
The full text of the story is accessible on the magazine's
World Wide Web site at http://money.com.
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