7 ms·

Doctors aren't pharmacists and especially not pharmacies

by homero 3y ago

alistairSH 3y ago
That's fair, however both my dermatologist and GP have started discussing the price of drugs they're recommending. It's an unfortunate effect of the state of medical care (the entire system) in the US.
dghughes 3y ago
My Dad's doctor was wonderful he worked with drug companies and was able to get my Dad's medication heavily rebated to the point his health coverage covered the difference. Anything else could be claimed on taxes. Dad would have had to pay about $40K for Esbriet (for IPF a lung disease), and $1,700 per dose once every two weeks for Humira. And other drugs too like morphine, prednisone, laxatives and so on. But basically it ended up being almost $0. Doctors do and can help a lot with drug costs. At least here in Canada the US who knows doctors probably get more in drug sales than anything.
- lotsofpulp 3y ago
  homero was not disputing that doctors can help, they were pointing out that the expectation of a doctor to know the ins and outs of someone's particular insurance plan and pricing of particular medicines is not reasonable, therefore irrational bringing up how the doctor neglected to mention a coupon in their story is an irrelevant detail since there should not be any expectation of doctors knowing about coupons for the medicine. Just like there should not be an expectation for the doctor knowing and telling you there is a coupon for vegetables at the grocery store if they tell you to eat more vegetables. If the doctor does know it, that is a bonus.
paulcole 3y ago
Doctors are in the business of helping people get healthy. And unfortunately in the US this is tied very tightly with finances. If a doctor in the US wants to be great at their job, they can’t ignore the financial component of their work — obviously some exceptions here like the doctors who work fee-for-service on the rich.
- alistairSH 3y ago
  No idea why you're being down-voted, as I agree completely. If a doctor recommends a treatment that the patient can't afford, and the patient doesn't discover that until days later at the pharmacy, that likely results in wasted time for all involved. The patient has to meet with the doctor again to discuss cheaper alternatives. Or forgo treatment, and risk more significant health problems, which lead to more cost in the future. My dermatologist almost always discusses the costs of treatments. One example - a topical cream is available as name-brand or generic. The generic is formulated at a higher strength but costs less. So, I can pay more for a gentler, slower treatment. Or save money, but get a harsher treatment. Both work fine, but after selecting the harsh generic once, I won't do that again - it works faster, but the side-effects were miserable.
sithlord 3y ago
This. It isn't the Doctors responsibility to know all the prices of things and such, they should know what meds you need for your ailment. I would say it would be good if your doctor found out about something (via a pharmaceutical rep or another patient) to pass that along, but not sure it makes sense for them to necessarily know the ends and outs of the current best coupon.
- cpuguy83 3y ago
  I disagree. A doctor better understand the economic impact the drugs they are prescribing to their patient.
  - Johnny555 3y ago
    Medical pricing is so hopelessly complicated that few doctors can even tell you what a procedure at they perform themselves at their own hospital will cost you. I don’t know how they could keep up with pricing for thousands of drugs interacting with formularies across hundreds of insurance plans.
    - not_a_shill 3y ago
      At least on the Rx side, it's really not that hard to have a general idea. Youre prescribing mostly the same medication over and over and patients give feedback, so knowing a general discount card price isn't difficult. If the patient has a weird formulary or a high deductible, that's on them to understand.
  - homero 3y ago
    Doctors couldn't get pricing even if they wanted to.
- LazyMans 3y ago
  A good doctor should be considering how to get the best outcome for a patient, availability and affordability is paramount if you intend to get a patient to follow through with a treatment. No, it's not the doctors "job" to make sure you can get your medication, but I don't think it's hard to argue a doctor that takes these things into consideration is better than one that lives in a bubble.
petesergeant 3y ago
I have had private doctors in the UK, Canada, Thailand, and Dubai all make sure I understand there are cheaper generics available of what they're prescribing, and many have also helped me understand where I can use pill cutters and other solutions to mean they can prescribe me more to save me money and make traveling cross-borders easy. The whole pharmacy coupon thing is an almost entirely American phenomenon. US and NZ are the only countries that allow direct-to-consumer marketing of drugs in the first place.
barbazoo 3y ago
True, but they often know the mechanics of the system and a hint that there might be a coupon would be almost zero work for them but incredible benefit to the recipient.
hibikir 3y ago
But they do get influence from the pharma companies, and might end up getting kickbacks for it. See the whole Auvi-Q situation, which discounts price to patient to zero, but charges far more than it's sensible to the insurance company: In practice insurance rates go up for everyone, the doctors that prescribe the expensive drug get more money, and the patient's discount make them pick said expensive drug. I've had very serious pushes from doctors to get medication like this.. the doctor was absolutely aware of the economics involved, including what was good for him. I thought I was not at a doctor's office, but dealing with a used car salesman.

Doctors aren't pharmacists and especially not pharmacies

by homero 3y ago

Doctors aren't pharmacists and especially not pharmacies

That's fair, however both my dermatologist and GP have started discussing the price of drugs they're recommending. It's an unfortunate effect of the state of medical care (the entire system) in the US.

dghughes 3y ago

My Dad's doctor was wonderful he worked with drug companies and was able to get my Dad's medication heavily rebated to the point his health coverage covered the difference. Anything else could be claimed on taxes. Dad would have had to pay about $40K for Esbriet (for IPF a lung disease), and $1,700 per dose once every two weeks for Humira. And other drugs too like morphine, prednisone, laxatives and so on. But basically it ended up being almost $0. Doctors do and can help a lot with drug costs. At least here in Canada the US who knows doctors probably get more in drug sales than anything.

lotsofpulp 3y ago
homero was not disputing that doctors can help, they were pointing out that the expectation of a doctor to know the ins and outs of someone's particular insurance plan and pricing of particular medicines is not reasonable, therefore irrational bringing up how the doctor neglected to mention a coupon in their story is an irrelevant detail since there should not be any expectation of doctors knowing about coupons for the medicine. Just like there should not be an expectation for the doctor knowing and telling you there is a coupon for vegetables at the grocery store if they tell you to eat more vegetables. If the doctor does know it, that is a bonus.

paulcole 3y ago

Doctors are in the business of helping people get healthy. And unfortunately in the US this is tied very tightly with finances. If a doctor in the US wants to be great at their job, they can’t ignore the financial component of their work — obviously some exceptions here like the doctors who work fee-for-service on the rich.

alistairSH 3y ago
No idea why you're being down-voted, as I agree completely. If a doctor recommends a treatment that the patient can't afford, and the patient doesn't discover that until days later at the pharmacy, that likely results in wasted time for all involved. The patient has to meet with the doctor again to discuss cheaper alternatives. Or forgo treatment, and risk more significant health problems, which lead to more cost in the future. My dermatologist almost always discusses the costs of treatments. One example - a topical cream is available as name-brand or generic. The generic is formulated at a higher strength but costs less. So, I can pay more for a gentler, slower treatment. Or save money, but get a harsher treatment. Both work fine, but after selecting the harsh generic once, I won't do that again - it works faster, but the side-effects were miserable.

sithlord 3y ago

This. It isn't the Doctors responsibility to know all the prices of things and such, they should know what meds you need for your ailment. I would say it would be good if your doctor found out about something (via a pharmaceutical rep or another patient) to pass that along, but not sure it makes sense for them to necessarily know the ends and outs of the current best coupon.

cpuguy83 3y ago
I disagree. A doctor better understand the economic impact the drugs they are prescribing to their patient.
- Johnny555 3y ago
  Medical pricing is so hopelessly complicated that few doctors can even tell you what a procedure at they perform themselves at their own hospital will cost you. I don’t know how they could keep up with pricing for thousands of drugs interacting with formularies across hundreds of insurance plans.
  - not_a_shill 3y ago
    At least on the Rx side, it's really not that hard to have a general idea. Youre prescribing mostly the same medication over and over and patients give feedback, so knowing a general discount card price isn't difficult. If the patient has a weird formulary or a high deductible, that's on them to understand.
- homero 3y ago
  Doctors couldn't get pricing even if they wanted to.
LazyMans 3y ago
A good doctor should be considering how to get the best outcome for a patient, availability and affordability is paramount if you intend to get a patient to follow through with a treatment. No, it's not the doctors "job" to make sure you can get your medication, but I don't think it's hard to argue a doctor that takes these things into consideration is better than one that lives in a bubble.

petesergeant 3y ago

I have had private doctors in the UK, Canada, Thailand, and Dubai all make sure I understand there are cheaper generics available of what they're prescribing, and many have also helped me understand where I can use pill cutters and other solutions to mean they can prescribe me more to save me money and make traveling cross-borders easy. The whole pharmacy coupon thing is an almost entirely American phenomenon. US and NZ are the only countries that allow direct-to-consumer marketing of drugs in the first place.

barbazoo 3y ago

True, but they often know the mechanics of the system and a hint that there might be a coupon would be almost zero work for them but incredible benefit to the recipient.

hibikir 3y ago

But they do get influence from the pharma companies, and might end up getting kickbacks for it. See the whole Auvi-Q situation, which discounts price to patient to zero, but charges far more than it's sensible to the insurance company: In practice insurance rates go up for everyone, the doctors that prescribe the expensive drug get more money, and the patient's discount make them pick said expensive drug. I've had very serious pushes from doctors to get medication like this.. the doctor was absolutely aware of the economics involved, including what was good for him. I thought I was not at a doctor's office, but dealing with a used car salesman.