Treat Medicines Like Netflix Treats Shows

Should the insurers costs be a factor in patient care? No.

Should pharmacists be paid by insurers to contra to cold call patients and interfere with the doctor patient relationship? No.

Should the pharmacists be financially incentivized to get patients to consent changes to therapies on the basis those changes lower insurers costs? No.

Should pharmacists be forced to do the bidding of the insurers under threat of being dropped from the insurance network? No.

Should doctors be forced to accept the insurers recommendations for changes to patient therapies under threat of being dropped from the insurers network? No.

It’s great to lower patient costs...and that’s what insurers and pharmacists on hanging their hat on, as I said almost no one knows the reality of how and why it’s being done. It’s no secret insurance companies are dropping pharmacies and doctors who don’t play ball (it’s worse for a patient to lose their network of doctors than pay for name brand drugs if the doctor feels that’s in their best interest). It’s also no secret that insurance companies are consolidating the market (buying pharmacies, buys hospitals and buying doctor offices) and forcing thei patients to the insurance owned doctors/pharmacies.

It can’t be ignored that patients are now often seeing a doctor owned by the insurer, filling their drugs at an insurance owned pharmacy...and decisions about patient care are made by the insurance company to lower their cost, not patient costs.

Those do exist, but not all doctors read them. However, those same doctors might spare 10 min to have a manufacturer rep stop by to answer questions.

I’ll also add that doctors aren’t dumb. They know anything from manufacturers is biased - they want to sell drugs. They usually rely on other physicians to give them info on real world experience with a drug.

This is a very odd view to take. I live in a single-payer system (Canada), although we don't have a similar system for prescriptions (yet). I have supplementary medical insurance through my work. Of course I want my insurer to keep costs low; that means more money to pay for important things, and lower costs for my employer (and by extension, me).

I take two regular prescriptions, and I happily accept generics, because they're cheaper and they work. If they didn't, and the name-brand would for some reason, then yes, I'd expect my insurer to pay for that. But to default to the lower-cost one is not a bad thing for patient care.

If you think the insurance companies are taking too much money from this relationship (I do) or if the whole idea of barely restrained medical capitalism is immoral (I do) or if insurance companies should have much less control over medical decisions (I do), I can understand that, but especially in the current system this is one of the few good ways to keep costs slightly lower.