An Urgent Message to Health Insurers From a California Doctor: In Medicine, One Size Does Not Fit All

Medicines intended to treat the same condition have different active ingredients and work in different ways.

Physicians should always be the ones to consider the many factors when they prescribe medicine for a patient, factors that insurance companies do not consider or even know about when they encourage switching.

But pressure by health care providers to switch to less costly drugs is stubbornly interfering in the physician-patient relationship. Patient safety and health is compromised when insurance companies meddle with treatment decisions made between physicians and patients.
Cost-driven switching affects not just individual patients but the entire health care system. The short-term savings that may result from switching to a less expensive substitute drug will inevitably be offset by higher costs in consultations with physicians, increase in prescriptions, increases in emergency room visits, as well as longer-term health consequences.

Considering that more than 34 million Americans suffer from high cholesterol, and nearly 65 million suffer from high blood pressure, pervasive insurance company-driven switching will have a major impact on the health of Americans.
Many minority medical practitioners also strongly believe that the growing substitution of generic drugs represents the rise of second-class form of medicine, especially for racial and ethnic groups, the elderly and others.

Minorities are being subjected to a form of social inequality that places them on the systemic “bottom shelves” which are stocked with cheaper, less effective, or questionably effective medications. The practice is insidious because it comes under the benevolent guise of cost-savings for low-income people.

But, cost-based drug switching carries even more risk to the poor, elderly and minority populations, groups that are already underserved. These patients should not be forced into substandard health care by the system simply because of their financial situation.
Physicians with stethoscopes, working closely with their patients, are the ones who should be making treatment decisions, and not insurance companies with calculators.

Richard Allen Williams, MD is a cardiologist and founder of the Minority Health Institute based in Encino, California. Dr. Williams edited the book Eliminating Healthcare Disparities in America, published in 2007.