Suggested Reading — Medicare’s Wasteful Prescription Practices and Why Docs Prescribe Name-Brand Drugs

As the nation wrestles with a major health-care overhaul, one program whose implementation nearly 40 years ago also was greeted with doubt and concern has more than met expectations. Medicare is universally embraced, but as a recent series of stories by the investigative news site ProPublica concludes, Medicare’s prescription medicine practices are astonishingly wasteful because administrators and some providers are careless at best, and incompetent at worst. And Congress often seems like it cares more about the big-spending medical industry lobbyists than patients.

In the first story, “Medicare’s Failure to Track Doctors Wastes Billions on Name-Brand Drugs,” ProPublica analyzed the prescribing habits of 1.6 million doctors and found that a tiny fraction have an outsized impact on the financial condition of Medicare’s massive drug program. And Medicare wastes money because it doesn’t rein in doctors who routinely give patients expensive name-brand drugs when less expensive generic alternatives are available.

The story also details how nearly half of the big-time brand-name prescribers have accepted thousands of dollars in promotional or consulting fees from drug manufacturers.

The second story, “Generic or Name-Brand? 10 Docs Talk About Picking Drugs,” ProPublica explained that name-brand drugs are appropriate in certain circumstances – when no equivalent generic is available; when patients have side effects from a generic drug; or for patients who are unusually sensitive to slight changes in its composition. But that’s a tiny percentage of cases.

So the reporters asked renowned practitioners why doctors prescribe the way they do, and their answers range from, essentially, the “glamour” of new drugs, patient pressure, a drug’s appearance, unawareness of cost, to the a sense that Medicare has no idea who’s doing what in the prescribing realm.