Show me the money! - US MD's incentivised to Rx generics

Once wooed by pharmaceutical giants with lavish gifts as a push to increase sales of their new drugs, doctors now are getting cash incentives from health insurance companies when they switch patients to cheaper generic medications.

The money is usually tied to how often doctors follow other measures to improve patients' health and cut costs, such as making sure patients get flu shots, immunizations and regular screenings for mammograms and colon cancer, or even having flexible office hours that help make doctors more accessible to patients.

Insurers' motivation for the incentives is simple: To cut costs. Generic drugs are much cheaper than brand-name medications. For example, some brand name cholesterol-lowering drugs cost more than $100 for a month's supply, while the cost for generics is under $10.

There are benefits to consumers, too, because generic drugs tend to come with cheaper co-pays.
A recent Blue Care Network program paid 2,400 Michigan doctors $2 million for switching patients to generic cholesterol-lowering drugs from brand-name drugs like Lipitor and Crestor. The insurer said it saved nearly $5 million. And the HMO expects members who switched will save a total of $1 million from lower co-payments this year.

Dr. Steven Bernstein, a University of Michigan professor of internal medicine, doesn't see the harm in paying physicians for generic switches, so long as the doctor takes the patient's health into account first.

"The more affordable that we can make medications for patients, the better off they could be," said Bernstein, who also is director of outcomes management for the U-M's faculty group practice.

Bernstein and his colleagues say insurers have been giving doctors financial incentives for years, and they're widely accepted within the industry because they generally reflect good clinical care.
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