A Dinner with Drug Reps: Dan Ariely

[urn2bfree]

After Lena's recent sugary the doc gave her a prescription for 30 norco pills. She didn't need a single one. Same for me once: 30 vicodins and I didn't need any.

Why is that?

First of all those would be filled as generic hydrocodone and not be promoted drugs- so you can't blame the reps for this...
I suspect that if Lena or you HAD pain post op and you did NOT have a prescription written -you- or many patients like you if not you- would have been mad at the doctor for not anticipating your needs...

 

[urn2bfree]

...
. 3/4 of the stuff he has prescribed to me has been more expensive than my insurance company is willing to pay for on an initial prescription, unless he justifies it in writing.

The other day the pharmacy said they needed insurance authorization and had faxed the request to the PCP's office. His nurse called me and asked why didn't I use the coupon they gave me. That miffed me a bit and I asked why they didn't just get authorization from the insurance company. My first reaction was to ask why they prescribed something they knew would not be covered, and then I remembered all the sales reps who are my doctor's biggest buds. They are in his office all day, every day, and they even buy him expensive meals. Little wonder he does them the occasional favor - on my dime.

If the man is going to prostitute himself to the drug companies that is his business, but I don't think I should be the one who pays for it.

What you say could be true--OR your PCP is prescribing a beter medicine for you than your insurance is willing to pay. Also- maybe with the coupon maybe it would have worked out cheaper for you than what the insurance wanted you to have...we don't know all the facts...when we do--maybe your PCP is being bought for the price of lunch--but if so-- again I would be concerned about your PCP's ability to think and synthesize medical knowledge as much as I would the PCP's ethics...

 

[TromboneAl]

I suspect that if Lena or you HAD pain post op and you did NOT have a prescription written -you- or many patients like you if not you- would have been mad at the doctor for not anticipating your needs...

Yes, I agree. But either we have an incredibly high tolerance for pain, or 30 pills is excessive. My question really is, "Why don't they have a refillable prescription for, say five pills?"

A friend said the same thing happened for her teenage son. The kid really wanted to use all the pills ("Hey, it's my prescription!"). It seems like a recipe for disaster.

 

[Moemg]

Yes, I agree. But either we have an incredibly high tolerance for pain, or 30 pills is excessive. My question really is, "Why don't they have a refillable prescription for, say five pills?"

.

Because a lot of people would go through the five pills in a day and have no way to get more . When I worked at the Surgery Center we called everybody the next day to see how they were doing and it was divided between people needing almost no medication and people complaining that the medications did nothing .

 

[Meadbh]

Yes, I agree. But either we have an incredibly high tolerance for pain, or 30 pills is excessive. My question really is, "Why don't they have a refillable prescription for, say five pills?"

A friend said the same thing happened for her teenage son. The kid really wanted to use all the pills ("Hey, it's my prescription!"). It seems like a recipe for disaster.

It is.

Prescription Drug Deaths Increase Dramatically: Scientific American

 

[meierlde]

Actually I suggest giving your PCP a copy of the $10/3 month list from your favorite store. Mine tried to foist a $60/month branded generic, off but I checked and got it down to the $10/3month by insisting that the generic be used. In fact I would tell the PCP that there is another advantage to generics, if there were going to be bad reactions to them they would have been found out before they became generic. It is so much easier to get info than in the past, one just needs to stand up for yourself. (And ignore all the drug adds)

 

[urn2bfree]

Actually I suggest giving your PCP a copy of the $10/3 month list from your favorite store. Mine tried to foist a $60/month branded generic, off but I checked and got it down to the $10/3month by insisting that the generic be used. In fact I would tell the PCP that there is another advantage to generics, if there were going to be bad reactions to them they would have been found out before they became generic. It is so much easier to get info than in the past, one just needs to stand up for yourself. (And ignore all the drug adds)

Knowing our own situation is a great idea and no doctor should mind...no doc can be expected to know the ins and outs of every insurance plan coverage...
I will only relate what I know- in cancer- a few years back- before any of them went generic -there were 3 different drugs all doing pretty much the same thing for breast cancer and for which there was absolutely no evidence for superiority of one vs the other. There was a fourth drug much cheaper and slightly less therapeutically preferred for side effect reasons. Which one is the doctor supposed to prescribe? The prices of the 3 safer drugs were similar and the difference in price would vary with the insurance and by which pharmacy they fill the prescription. It is not reasonable to add this chore to the doctor to know which med will cost which patient how much... It is all too complicated...often it came down to which med had free samples in the office...so the pt could try it for free for 2 weeks or a month before filling the prescription. The company rep provides the samples.

 

[Bimmerbill]

I wish I had the personality to be a drug rep. I know several, including a cousin, and the money they make is pretty good!