Prescriptions shouldn’t push brand name drugs

TheStar.com – Opinion/Editorials – There’s a lot of money at stake in selling brand name drugs over generic ones. Now the battle for our bucks has gone behind the scenes with a new software tool physicians say encourages the use of brand name drugs. Doctors should shut it down.
July 31, 2017.   By

It sure is a financial win-win for brand name drug companies and Telus Health, a subsidiary of the telecom giant.

But a software tool that Telus has written into its electronic patient records system could prove to be a setback in the war to lower drug prices in Canada by favouring brand name drugs over cheaper generic ones.

The tool, used the moment a prescription is being written by a doctor, also raises privacy concerns for patients, among other issues.

In short, it should be removed from Telus’s electronic patient records system, and that of any physician software programs made by other companies.

As the Star’s Jesse McLean and David Bruser report, thousands of Canadian doctors use the software to take notes during patient visits and create a prescription to be filled by the patient’s pharmacy.

To encourage pharmacists to fill the prescription with their brand name drug, pharmaceutical companies have paid Telus (the company won’t say how much) to digitally insert vouchers on the prescription so that pharmacists will reach for their drug rather than a lower-cost generic made by a competitor.

The vouchers work like a coupon. If a patient’s insurance plan does not cover the full cost of the pricier brand name drug, the drug’s manufacturer will cover all or part of the cost difference from its generic equivalent.

The program is rife with potential — and costly — problems.

First, it undermines the ability of generic drug manufacturers to compete. The voucher program could threaten the viability of their businesses and eventually reduce competition in the expensive pharmaceuticals field. That, in turn, would leave doctors increasingly reliant on brand name medicines which could dramatically bump up drug prices across the country.

Second, while a Telus spokesperson insists that voucher plans are not designed to add costs to private plans, they could have that effect. In some cases, for example, if a patient’s plan does not cover the full cost of a brand name drug, then the cost can end up being charged to the health plan of the patient’s spouse — not to the drug company.

Helen Stevenson, a former Ontario assistant deputy health minister, says the vouchers can pile unnecessary costs onto private drug plans. These costs could ultimately be passed to patients though higher premiums.

Third, this tidy little deal between Telus Health and brand name drug companies does not benefit the consumer. Generic drugs provide the same benefits as brand name ones, but cost less.

Finally, there is a privacy concern. “There will certainly be a number of physicians who will be concerned they are inadvertently participating in contributing data to pharmaceutical companies,” Dr. Monica De Benedetti and colleagues at the Hamilton Family Health Team wrote to Telus in a complaint letter.

For its part, Telus Health insists it has only shares with drug companies the total number of vouchers that are printed off for their products. No patient or physician information is shared, the company says.

Still, data systems have a way of being compromised and, regardless, doctors may not want to contribute any market information to pharmaceutical companies at all.

The good news? The software, which allows physicians to opt in at any time, also allows them to opt out. All doctors using the system should do that now.

https://www.thestar.com/opinion/editorials/2017/07/31/prescriptions-shouldnt-push-brand-name-drugs-editorial.html

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