The Angry Pharmacist on the Medicare donut-hole

He contends Medicare Part D causes physicians to prescribe more brand name drugs:

You have a patient who is on Medicare Part D. Suddenly, all of these new and spiffy trade-name medications are only $3.10! So what does the doctor do? He starts writing for that ARB when a generic ACE-I is okay. He starts writing for Lipitor when the patient has been on generic Zocor for months. He starts . . . prescribing Levaquin when generic Cipro would be okay. “Hell! Its only $3.10! Why not! The patient only pays $1 for generics, whats another $2.10 for a drug that works ‘better’!!!”.

I’ll have to dispute that. I don’t think I’ve ever gone generic to brand-name because of Medicare Part D. Regarding the fluoroquinolone comment, there are cases where broader spectrum antibiotics like Levaquin and Avelox are better clinical choices than Cipro.

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