WSJ Examines Financial Incentives for Physicians To Switch Patients to Less-Expensive, Generic Medications
The Wall Street Journal on Thursday examined how some health insurers are "drawing scrutiny for offering financial incentives" as part of efforts to encourage physicians to switch patients from brand-name medications to less-expensive, generic treatments.
According to the Journal, although large pharmaceutical companies "have long gone to great lengths" and have invested "billions of dollars plying physicians with samples, educational lunches and speaker fees" to promote their products, health insurers are "trying to trump those perks" with monetary gifts and higher reimbursements. Health insurers maintain that increased use of generic medications will reduce costs for patients, employers and health care providers, and many physicians "argue that it's only right to reimburse them" for the time required to determine whether less-expensive, generic medications are "better or as good" for patients than brand-name treatments, the Journal reports.
However, lawmakers and patient advocacy groups have raised concerns that "injecting financial incentives into what ... should be a purely medical decision" could affect quality of care, and medical societies maintain that the practice places physicians in the "ethically questionable position of taking a payment that patients know nothing about," according to the Journal. In response to concerns about the practice, the American Medical Association recently published an online advisory titled "Kickback Questions and Answers." According to the advisory, "Accepting payment for moving a patient from a brand name to a generic could be viewed as an anti-kickback statute violation" (Fuhrmans, Wall Street Journal, 1/24).
