Doctors regularly give in to patient pressure to prescribe brand-name drugs

Tuesday, January 22, 2013 by: David Gutierrez, staff writer
Tags: brand-name drugs, doctors, patients

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(NaturalNews) Nearly 40 percent of all physicians regularly give in to patient requests to prescribe a brand-name drug, even when an equally effective generic substitute is available, according to a survey conducted by researchers from Massachusetts General Hospital and published in the journal JAMA Internal Medicine (formerly Archives of Internal Medicine).

Doctors who reported marketing relationships with pharmaceutical companies were significantly more likely to report having yielded to such requests.

The survey was send to 3,500 physicians across the United States, 500 each from the specialties of anesthesia, cardiology, family practice, general surgery, internal medicine, pediatrics and psychiatry. The researchers received nearly 1,900 responses.

Doctors were asked whether, in the past year, they had "prescribed a brand-name drug when an equivalent generic was available because the patient asked for the brand-name drug specifically." Physicians were able to answer "never," "rarely," "sometimes" or "often."

Almost 40 percent of respondents answered either "sometimes" or "often."

"The good news is that 63 percent of physicians indicated they never or rarely prescribed a brand-name drug instead of an equivalent generic simply because of a patient request," lead researcher Eric G. Campbell said. "However, our data suggest that a substantial percentage - 37 percent or about 286,000 physicians nationally - do meet those requests.

"Since generics are from 30 to 80 percent cheaper than the brand-name versions, that would represent a significant source of unnecessary health costs."

Pharmaceutical companies exert strong influence

Upon analyzing the data, the researchers found that doctors who had been practicing for more than 30 years were significantly more likely than others to fulfill patient requests. Doctors in solo or two-person practices were also more likely to give in. The specialties in which doctors were most likely to give were internal medicine and psychiatry.

Doctors who had received food, beverages or drug samples from the pharmaceutical industry were significantly more likely to prescribe brand-name drugs. The study did not find any connection, however, between prescribing practices and larger gifts from drug companies, such as speaking or consulting fees, gifts, or travel reimbursements.

"While we cannot prove a cause-and-effect between industry marketing activities and prescribing practices, at the most basic level these data suggest that industry marketing works," Campbell said. "Our results also raise serious doubts about the desirability of meeting with drug company representatives to 'stay up to date'."

"Reducing or eliminating this practice represents low-hanging fruit in terms of reducing unnecessary spending in medicine," co-author Christine Vogeli said. "However, doing so will likely be unpopular with some patients, physicians and certainly with the drug industry."

Measures to reduce unnecessary prescribing of brand-name drugs could include programs to educate patients, who are often influenced by drug-company advertising. The authors also suggested that hospitals and health-care systems could ban industry gifts of food and beverages, and require the dispensing of drug samples only through their pharmacies rather than directly from doctors. They also suggested that the United States adopt the system already in place in the Veteran's Health Administration, where pharmacists decide whether to dispense a brand-name or generic drug, except under special circumstances..

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