Why doesn’t my doctor prescribe generics?

A letter in the L.A. Times today from a man in Oceanside, California stated the following:

“I read with great interest [“Under the Influence“] in the Aug. 6 Health section because I, at one time, would only use brand-name medications.  Even though I belong to a Medicare HMO, the co-pays sometimes were quite substantial.  I was forced to buy some of my medications from Canada, the United Kingdom and even Israel.

I started to ask my primary physician for generics, and to my surprise he was able to find generics that served the same purpose as the nationally advertised drug.  Today I use only generics — except in one instance, because there is no generic yet on the market.

It is entirely up to patients to insist that their physician prescribe generics whenever possible. It is amazing how much money they could save.”

Patients almost always assume that physicians have only their best interest at heart.  This is not always the case.  Physicians must comply with managed care directives, are often influenced by the free lunches and dinners handed out by drug companies and may prescribe conservatively to avoid malpractice issues.  Even your doctor acts 100% in your medical interest, it is unlikely that they will act in your financial interest.  Since the doctor is not paying for the pharmaceutical–the doctor likely does not know if you or your insurance company is paying for the drug–they do not have any incentive to prescribe based on cost.  As the gentleman from Oceanside stated, “It is entirely up to patients to insist that their physician prescribe generics…”