Doctors Paid To Switch Patients To Generic Drugs

October 29, 2009

seems they pay doctors to put patients on these drugs (Statins) too......

What an UGLY scenario huh? follow the almighty $$$

http://www.thebostonchannel.com/news/13800173/detail.html

Incentives Raise Ethical Questions

October 29, 2009

Doctors Paid To Switch Patients To Generic Drugshttp://www.thebostonchannel.com/news/13800173/detail.htmlIncentives Raise Ethical Questions Email PrintBOSTON -- Team 5 Investigates discovered that health insurers are giving doctors incentives, sometimes in cash, to switch patients to generic brands.NewsCenter 5's Janet Wu reported Wednesday that the payments are legal, but health care experts said they clearly raise ethical questions if patients are not told the reasons behind the switch.Much of the controversy centers on the cholesterol drug Lipitor, which is the best-selling medicine in the world. It is currently under a patent and does not have a generic version. Thousands of Massachusetts patients recently discovered their insurer won't pay for it anymore or that their out-of-pocket cost has skyrocketed. Other patients told Team 5 Investigates they were switched by their physicians with little explanation.Earlier this year, Blue Care Network in Michigan paid 2,400 doctors $2 million to switch their patients from Lipitor to a generic version of its competitor, Zocor. They were paid $100 for each patient they switched from Jan. 1 through March 31, 2007.“Without saying to the patient, ‘I have a financial incentive in making this decision, which goes along with my professional incentives to do what's right for you,’ it's unethical,” said professor Regina Herzlinger, of Harvard Business School. “It's a clear conflict of interest.”Team 5 Investigates asked Blue Care Network of Michigan if patients were told of the financial kickback.A spokeswoman said "not specifically."In Massachusetts, financial arrangements for switching patients from Lipitor are less blatant, but they do exist.In a letter obtained by Team 5 Investigates, Partners Community HealthCare's Medical Director, Dr. Thomas Lee, told his colleagues that "physicians will increasingly be rewarded in our pay-for-performance contracts if we increase the percent of generics we use. Increasing our use of generic statins is therefore very much to our advantage."Former Lipitor patient Genie Holland told Wu, “I'm shocked. They're paying the doctors? Yes. I'm shocked.”Holland said she was surprised earlier this year when her doctor switched her from Lipitor to a generic version of Zocor without explanation, “because it had worked for me for so long. I also found that my cholesterol went up after I went on the generic.”But Herzlinger said the medical efficacy is irrelevant to this debate. “You've got to tell the patient that 'I'm switching you to a generic, not only because it's best thing for you and it's going to save you money out-of-pocket, but because I'm going to make more money as a result of that.'”Here in Massachusetts, arrangements vary according to the insurance plan. Some doctors get a cash bonus at the end of the year for various money-saving practices, including switching their patients to generics.Another patient whose doctor switched her from Lipitor to a generic version of Zocor said, “It really is upsetting to think they would get a kickback from using certain drugs.” That patient has taken several cholesterol medications over 10 years and had the best results with Lipitor, but she, too, was recently switched to a generic with little explanation.Doctors with whom NewsCenter 5 spoke, including Dr. Robert Fraser, said they moved most people off Lipitor because patients save money. He said he gets a kickback for only some of his patients, depending on their insurer.“Well, the problem is I don't know which patient I'm seeing at that moment. If you walk into my office and at that second, I don't know if you're an HMO patient or not.”