Antibiotic-Resistant-Crisis-thumbnailEven when generic drugs are available, approximately 4 of 10 physicians in practice more than 30 years “sometimes or often” give in to patients’ demands for brand-name drugs. This is compared with 31% of physicians in practice for 10 years or less.

Data taken from a national survey of 3,500 randomly sampled physicians across 7 specialties was published in this week’s JAMA Internal Medicine. The numbers suggest that the unnecessary healthcare system costs associated with this practice may be substantial.

Physicians who worked primarily in a solo or 2-person practice, received free food and/or beverages in the workplace (39% vs 33%) or drug samples (40% vs 31%), or met industry representatives to stay up to date (40% vs 34%) were more likely to yield to patients’ demands. Additionally, physicians in internal medicine (50%), psychiatry (50%), cardiology (44%), and family practice (39%) were more likely to prescribe brand-name drugs.

The researchers suggest that a potential intervention that could dramatically reduce this practice includes having a closed health system (such as the Veterans Health Administration). This would give the pharmacy primary control over these decisions, with override capability for rare situations when necessary (eg, allergy to generic additive).

Do you agree with these findings? Do you agree a closed health system is the answer?