Coupons like that come from the manufacturer, and are given to doctors by drug sales representatives. Many practices don't allow drug reps any more, so the doct

Coupons like that come from the manufacturer, and are given to doctors by drug sales representatives. Many practices don't allow drug reps any more, so the doctors in those practices don't learn about the coupons. Disclosure laws curb the worst historical excesses, and there are good arguments in favor of further restrictions. Good reps serve an educational purpose, and when the medicines available to treat a disease have evolved dramatically, that education can be necessary. For example, there are still primary care physicians who just go to sulfa drugs then insulin after metformin. There are much better medicines that actually protect other organ systems too! But they didn't learn about them in med school, and it takes some consistent nudging to get them to break the old prescribing habits.