Lavish meals at expensive restaurants, $100 as you leave the room for your time, a percentage payment back for prescribing certain drugs, this sounds like a clear violation of the PhRMA code. But wait, this is your local insurance company encouraging doctors to use generic drugs. For this practice you would expect to see outrage from state governments, letters from Senators…. apparently not if you are an insurance company trying to save money.
This was the description of practice becoming more common for insurance companies in the Associated Press: Insurers entice doctors to prescribe generic drugs. The difference is that insurance companies don’t have to comply with the same rules as medical manufactures so they can pay physicians to attend meetings and lavish expensive meals on them and even give them kickbacks for prescribing generic drugs.
Independent Health, a Buffalo, N.Y.-based insurer, offered doctors who prescribe 70 percent or more generic prescriptions in a month a bonus of 50 cents per patient per month. A doctor seeing 500 patients per month who meets the 70 percent minimum can collect $3,000 a year.
John Rodgers, executive vice president and chief marketing officer for Independent Health, said the incentive program rewards doctors for prescribing generics when possible — but it doesn't punish them if they don't.
"Our plan doesn't agree to force people off of a drug if a person makes a personal choice they can continue that drug with a higher co-pay," he said.
Switching patients to generic drugs is not without risks, many generic drugs are not equivalent to branded newer medications or work differently in different patients.
Another practice that I have seen recently is Academic Medical Centers offering CME dinners for physicians at fancy restaurants to come out and find out about their latest diagnostic test or procedure.
The rules for hospitals and insurance companies are completely different than manufacturers. The regulators have focused on just one type of conflict at the expense of all others.
Associated Press: Insurers entice doctors to prescribe generic drugs