June 1, 2009
By Robin Robinson
Another fly in the ointment, brought to light by DrugWonks’ pundit Peter Pitts, president of the Center for Medicine in the Public Interest and Partner and Director of global healthcare at Porter Novelli, lies in how much power the payer, whether private or government, has to overrule a physician’s prescribing wishes to save money. (Drugwonks.com is the Web log of the CMPI, a forum offering rigorous and compelling research on the most critical issues affecting current drug policy.)
“If a universal insurance program is created that allows a patient to fill the prescription that the physician has requested and get reimbursed for it, I would say, ‘That’s wonderful,’” Mr. Pitts acknowledges. “But how socialized medicine usually plays out, especially in the United Kingdom, is that a physician prescribes a certain drug that he or she feels is best for the patient’s personal medical condition and the government or private payer will only reimburse for the less expensive generic version.”
At this point, the discussion is no longer focused on patient outcomes but rather on cost, Mr. Pitts says, and he finds this practice unacceptable. “A reimbursement system that gives broader access to mediocre care as opposed to excellent care is not healthcare reform,” he says.
