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And drug makers are aware of this fact thus they incentivize doctors to specify the brand name drug.

chimeracoder 9y ago
> And drug makers are aware of this fact thus they incentivize doctors to specify the brand name drug. That's a bold and unfounded claim. Drug makers do not incentivize doctors to write DAW on a prescription.
- cptskippy 9y ago
  > That's a bold and unfounded claim. Forbes and the New York Times have written articles on it. The Affordable Care Act has a provision that requires Doctors to disclose payments. Empirically, I dated a girl for about 2 years who was a sales representative for a major pharmaceutical company. When I asked about her job she said it was mostly dropping of brochures, swag, free lunches, and holding contests to promote products. Top producers (doctors) received all expense paid trips to medical conferences held in exotic locations or were invited to be paid speakers at said conferences. It was not too different from what the marketers did at the insurance broker I worked for at the time to cater Agents to write their lines.
  - chimeracoder 9y ago
    > Empirically, I dated a girl for about 2 years who was a sales representative for a major pharmaceutical company. When I asked about her job she said it was mostly dropping of brochures, swag, free lunches, and holding contests to promote products. Top producers (doctors) received all expense paid trips to medical conferences held in exotic locations or were invited to be paid speakers at said conferences. It was not too different from what the marketers did at the insurance broker I worked for at the time to cater Agents to write their lines. Your anecdote is about which drugs the doctors choose to prescribe. It has nothing to do with incentivizing doctors to prevent patients from filling generic versions of drugs and forcing them to purchase the brand-name version of the same drug, which is what this thread is about.
    - cptskippy 9y ago
      They weren't compensating them to fill scripts for the generic. She made more frequent visits to top producers based on filled prescriptions. I asked her how she knew who to visit and she said she was emailed regional reports with prescription numbers. I don't know how those reports are generated. Do pharmacies report that information back to pharmaceutical companies? Are they based off of shipments to regions?
      - chimeracoder 9y ago
        > They weren't compensating them to fill scripts for the generic. They're not out there to make sales for old drugs (drugs that have gone generic). They're out there to make sales for new drugs, which don't have generic equivalents at all. No pharmaceutical company is going to waste money on sales for drugs that have gone generic, and certainly no pharmaceutical company is going to try and incentivize providers to DAW prescriptions. Aside from being already illegal, even an unscrupulous company wouldn't bother because it'd be a tremendous waste of money.
thesimon 9y ago
And this makes the pharmacy give you the brand name drug? That's surprising. Over here (Germany) the doctor can fill in the name of the brand in the prescription, but unless he ticks a special box you'll automatically get the generic.
- pbhjpbhj 9y ago
  Why would a pharmacy give you a brand name, the generic is chemically identical, the doctor can give a brand name - they've done their part. The pharmacy could then offer you the brand name, or the generic, as long as they make the generic cheaper then the pharmacy can make more money; save you money and give identical service. Some people will still opt for the more expensive, of course, but where's the incentive for the pharmacist to fill a script for Neurofen RTM with anything other than ibuprofen? Why even is there a special box -- if the generic isn't the same drug (tested, licensed, etc.) it's not a generic. Might as well have a "are you getting a kickback for prescribing this" box?
  - stordoff 9y ago
    Generics aren't always chemically identical. The active ingredient might be the same, but the binders may not be. In the majority of cases, that's fine - you only really care about the active ingredient - but in certain cases, such as a sensitivity to one of those ingredients, it might not be. My sister has had to have specific brands of certain medicines prescribed due to a sensitivity to certain types of sugars. For instance, compare Neurofen: > Each tablet contains Ibuprofen 200 mg Also contains: Sucrose, Sodium Citrate, talk, Croscarmellose Sodium, Stearis Acid, Titaniu, Dioxide, Silicon Dioxide, Acacia, Carmellose Sodium, Sodiu, Laurilsulphate, Macrogol and Blank Ink(contains Shellac, Iron Oxide Black (E172) and Propylene Glycol) or Opacode S -1 -8152 HV Black (contains Shellac, Iron Oxide Black (E172, Antifoam DC1510 and Soya Lecithin https://www.boots.com/nurofen-200mg-tablets-16-tablets https://www.boots.com/nurofen-200mg-tablets-16-tablets to generic ibuprofen: > Ibuprofen 400mg, sodium starch glycollate, croscarmellose sodium, sucrose, E171, E127 and E211 https://www.chemistdirect.co.uk/ibuprofen-400mg-tablets/prd-i5j https://www.chemistdirect.co.uk/ibuprofen-400mg-tablets/prd-...

> And drug makers are aware of this fact thus they incentivize doctors to specify the brand name drug. That's a bold and unfounded claim. Drug makers do not incentivize doctors to write DAW on a prescription.

cptskippy 9y ago
> That's a bold and unfounded claim. Forbes and the New York Times have written articles on it. The Affordable Care Act has a provision that requires Doctors to disclose payments. Empirically, I dated a girl for about 2 years who was a sales representative for a major pharmaceutical company. When I asked about her job she said it was mostly dropping of brochures, swag, free lunches, and holding contests to promote products. Top producers (doctors) received all expense paid trips to medical conferences held in exotic locations or were invited to be paid speakers at said conferences. It was not too different from what the marketers did at the insurance broker I worked for at the time to cater Agents to write their lines.
- chimeracoder 9y ago
  > Empirically, I dated a girl for about 2 years who was a sales representative for a major pharmaceutical company. When I asked about her job she said it was mostly dropping of brochures, swag, free lunches, and holding contests to promote products. Top producers (doctors) received all expense paid trips to medical conferences held in exotic locations or were invited to be paid speakers at said conferences. It was not too different from what the marketers did at the insurance broker I worked for at the time to cater Agents to write their lines. Your anecdote is about which drugs the doctors choose to prescribe. It has nothing to do with incentivizing doctors to prevent patients from filling generic versions of drugs and forcing them to purchase the brand-name version of the same drug, which is what this thread is about.
  - cptskippy 9y ago
    They weren't compensating them to fill scripts for the generic. She made more frequent visits to top producers based on filled prescriptions. I asked her how she knew who to visit and she said she was emailed regional reports with prescription numbers. I don't know how those reports are generated. Do pharmacies report that information back to pharmaceutical companies? Are they based off of shipments to regions?
    - chimeracoder 9y ago
      > They weren't compensating them to fill scripts for the generic. They're not out there to make sales for old drugs (drugs that have gone generic). They're out there to make sales for new drugs, which don't have generic equivalents at all. No pharmaceutical company is going to waste money on sales for drugs that have gone generic, and certainly no pharmaceutical company is going to try and incentivize providers to DAW prescriptions. Aside from being already illegal, even an unscrupulous company wouldn't bother because it'd be a tremendous waste of money.

thesimon 9y ago

And this makes the pharmacy give you the brand name drug? That's surprising. Over here (Germany) the doctor can fill in the name of the brand in the prescription, but unless he ticks a special box you'll automatically get the generic.

pbhjpbhj 9y ago
Why would a pharmacy give you a brand name, the generic is chemically identical, the doctor can give a brand name - they've done their part. The pharmacy could then offer you the brand name, or the generic, as long as they make the generic cheaper then the pharmacy can make more money; save you money and give identical service. Some people will still opt for the more expensive, of course, but where's the incentive for the pharmacist to fill a script for Neurofen RTM with anything other than ibuprofen? Why even is there a special box -- if the generic isn't the same drug (tested, licensed, etc.) it's not a generic. Might as well have a "are you getting a kickback for prescribing this" box?
- stordoff 9y ago
  Generics aren't always chemically identical. The active ingredient might be the same, but the binders may not be. In the majority of cases, that's fine - you only really care about the active ingredient - but in certain cases, such as a sensitivity to one of those ingredients, it might not be. My sister has had to have specific brands of certain medicines prescribed due to a sensitivity to certain types of sugars. For instance, compare Neurofen: > Each tablet contains Ibuprofen 200 mg Also contains: Sucrose, Sodium Citrate, talk, Croscarmellose Sodium, Stearis Acid, Titaniu, Dioxide, Silicon Dioxide, Acacia, Carmellose Sodium, Sodiu, Laurilsulphate, Macrogol and Blank Ink(contains Shellac, Iron Oxide Black (E172) and Propylene Glycol) or Opacode S -1 -8152 HV Black (contains Shellac, Iron Oxide Black (E172, Antifoam DC1510 and Soya Lecithin https://www.boots.com/nurofen-200mg-tablets-16-tablets https://www.boots.com/nurofen-200mg-tablets-16-tablets to generic ibuprofen: > Ibuprofen 400mg, sodium starch glycollate, croscarmellose sodium, sucrose, E171, E127 and E211 https://www.chemistdirect.co.uk/ibuprofen-400mg-tablets/prd-i5j https://www.chemistdirect.co.uk/ibuprofen-400mg-tablets/prd-...