An interesting story from Boston Channel Five News on that exposes some of the hidden incentives behind medication switching. We all know that generic medicines are cheaper and are effective, most of the time. However, two pieces of information are often not conveyed, or conveyed effectively, when a switch takes place. The first is whether you are getting the same molecule or compound (generic switch) or whether you are getting a totally different one in the same class (therapeutic switch). Generic switching is often mandated by state law and the differences you may notice are most likely due to differences in the amount of active ingredient (generics are allowed a plus or minus 20% from the stated amount; brand-name generally adhere to plus or minus 5% of stated amount).
Therapeutic switching, on the other hand, is a completely different story. You are getting a different compound with different efficacy, different side-effects, and different drug-to-drug interactions. Patients need to be vigilant for these switches not only for the reasons already mentioned, but also because the reason for the switch may not be your health or your pocket-book. It may be due to insurance companies essentially paying physicians (and other prescribers) to switch you. Insurer contracts often include bonus payouts if the physician meets an arbitrary percentage of generic prescribing -- high 80 percent is the current target among many Massachusetts physicians.
Take a look at the news coverage to learn more about this practice and what the AMA are doing to combat this insurer practice. VIDEO HERE
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