Are doctors needlessly raising the costs of America's healthcare system through their prescribing habits? Absolutely, say researchers. A new report appearing in the Jan. 7 issue of JAMA Internal Medicine highlighted the powerful role played by branded drug advertising on consumer preferences and physicians' prescribing habits, and asserted that many doctors ignore the cost-saving benefits of generic drugs when writing prescriptions by acceding to patients' wishes.
"Approximately 4-of-10 physicians report that they sometimes or often prescribe a brand-name drug to a patient when a generic is available because the patient wanted it," researchers reported in JAMA. "These numbers suggest that the unnecessary costs associated with this practice to the healthcare system could be substantial."
The JAMA report is based on a survey — conducted by the Harvard Medical School and the Colorado School of Public Health — of 1,891 randomly sampled prescribing physicians practicing in seven medical specialties. Approximately 37% of the doctors surveyed told researchers that in many cases they prescribe a specific branded drug the patient asks for, rather than an available generic alternative, despite the higher costs involved.
Advertising by pharmaceutical companies prompts many patients to pressure their doctors for the brand-name prescription drug, the report suggested. "Prescribing brand-name drugs when generic drugs are available generates unnecessary medical expenditures, the costs of which are borne by the public in the form of higher co-payments, increased health insurance costs and higher Medicare and Medicaid expenses," the report noted.
The result is "is a huge source of wasteful spending that can be prevented," wrote Eric Campbell, professor of medicine at Harvard Medical School and team leader of the study. Researchers found that older physicians are more likely to acquiesce to their patients' requests for the branded medicine. The survey, the authors noted, "shows that 43% of physicians in practice more than 30 years sometimes or often give in to patients' demands for brand-name drugs compared with 31% physicians in practice for 10 years or less."
In addition, doctors "working primarily in sole or two-person practices were significantly more likely to acquiesce to patient demands than those working in a hospital or medical school setting [46% vs. 35%]," JAMA reported. But pediatricians, anesthesiologists, cardiologists and general surgeons "were significantly less likely to acquiesce patient demands relative to internal medicine physicians."
The Generic Pharmaceutical Association was quick to seize on the survey findings. "The JAMA Internal Medicine study demonstrates that we are still leaving savings on the table that could be achieved by increasing the use of generic drugs," GPhA president and CEO Ralph Neas asserted.