Joseph Paduda's weblog on managed care for group health, workers compensation & auto insurance, covering health care cost containment, health policy, health research, and medical news for insurers, employers, and healthcare providers.

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Why MDs prescribe Vioxx

DB's Medical Rants has an interesting discussion re why MDs prescribe Vioxx, Celebrex, etc. As MDs are the ones ultimately driving prescription volume, it bears reading.

HSA (my firm) is completing a study of prescription drug management in Workers' Comp - one of the very preliminary findings is the strong opinion among WC payers that MDs are in large part responsible for Rx cost inflation.

Payers are frustrated that MDs are prescribing drugs patients don't need, driving up short term costs with no attendant benefit to patients. Meanwhile, these decisions may very well lead to additional costs, as patients suffering cardiovascular events who also took COX-2s for WC injuries seek compensation from their WC payer.

The net - payers see MD prescribing behavior as abdicating responsibility, and increasing payer costs. Frustration is rampant.

Comments

So, if doctors really are "prescribing drugs patients don't need, driving up short term costs with no attendant benefit to patients,"
the question becomes, "Why are they doing that?"

the short answer is due to DTC advertising, pharma detailing, and patient demand. The longer answer is posted on RCentors's blog - http://www.medrants.com/.

Another way to look at this is - MDs are prescribing these drugs because payers are paying for them. If payers would not pay for them, I doubt MDs would write the scripts. But, and admittedly this is a big but, that would require a major shift in PBM and prescription management...

Joseph Paduda is the principal of Health Strategy Associates.

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