Healthcare costs

[disneysteve]

"Hi, I am the government, I just want ONE drug with good effectiveness(doesn't have to be the best)/good side-effect profile/and CHEAP). I will add this ONE drug into our national formulary

I'm not necessarily opposed to something in that direction, but then what happens to the patient who can't tolerate that ONE drug or for whom that ONE drug doesn't work? Will there still be a simple process in place for his doctor to prescribe one of the competing products? There is no one drug that works and is tolerated by every patient every time.

Also the university will specialize in making NEW drugs and not some rehash nonsense these drug companies come out yearly just to remix their patents.

Yes, those "new and improved" drugs drive me crazy. Most of the time they offer little to no actual advantage. There is something to be said for a once-daily version of a drug rather than one that needs to be taken 2 or more times a day as it improves compliance significantly but there are plenty of other examples of "new" drugs that offer absolutely nothing new. A perfect example is a new insulin product that came out last year called Basaglar. It is identical - actually the exact same amino acid sequence - to Lantus, a product we've used for years. I still don't know why it got FDA approval. There is nothing novel, unique, or better about it than Lantus. It is a little cheaper, but that's probably because the company didn't have to do all of the research that the makers of Lantus had to do.

No more drug commercials, no more drug reps stalking MDs giving them vacations so they can prescribe their version of the same thing

I'm totally with you on drug commercials. I think those should never have been allowed in the first place. Leave the prescribing decisions in the hands of the prescribers, not in the hands of the patients.

As for the drug reps, I feel obligated to point out that the vacations, concert tickets, golf outings, and the like ended years ago. It was at the end of 2008. Since then, we can't get so much as a paper clip from a drug company. We can still get a meal but there are pretty strict guidelines on those.

[Singuy]

I'm not necessarily opposed to something in that direction, but then what happens to the patient who can't tolerate that ONE drug or for whom that ONE drug doesn't work? Will there still be a simple process in place for his doctor to prescribe one of the competing products? There is no one drug that works and is tolerated by every patient every time.

Obviously we can't just have one drug on the formulary. But it's the ONE drug that is heavily subsidized by the government and the drug company because 95% of the pts will be on this drug. Other drugs will be on it as well but at a much higher copay(kind of like our formulary system now that's in tiers). Also it requires a prior auth for an approval. The point is, the drug company with the more expensive options can only pick the bones of the population and can't ever get to the meat unless they have a hit cheap drug under their belts.

[Singuy]

As for the drug reps, I feel obligated to point out that the vacations, concert tickets, golf outings, and the like ended years ago. It was at the end of 2008. Since then, we can't get so much as a paper clip from a drug company. We can still get a meal but there are pretty strict guidelines on those.

Drug reps are making over 100k/year so I'm sure these companies are not paying them to sit around. If not vacations, then some other ways that brings nothing to the healthcare table except to drive up drug cost(cause someone has to pay them that 100k).

[disneysteve]

Drug reps are making over 100k/year so I'm sure these companies are not paying them to sit around. If not vacations, then some other ways that brings nothing to the healthcare table except to drive up drug cost(cause someone has to pay them that 100k).

I'm not disagreeing, but your comment about vacations was just perpetuating an old stereotype that is no longer true.

As a practicing physician, though, I have to say I see a lot of value in the drug reps calling on my practice. If not for them, I really would struggle to keep up with advances in medicine. I don't have time to sit and learn about all of the new drugs that come out. Even if I don't use them, it's important for me to know about them because a patient may get put on something by another doctor and I need to be familiar with it. And, of course, a lot of those newer drugs do become standard of care. The meds we have available to us today are far, far better than what we had not all that long ago. So even though the reps can't give me theater tickets or take my wife and I out for dinner or give us pens or post-it note pads anymore, they definitely serve an important educational purpose.