Zip,
Here is an article from the New Yorker:
http://www.newyorker.com/archive/2004/10/25/041025crat_atlargeIt addresses the costs of prescription drugs specifically with Nexium/Prilosec as an example.
I 100% agree with the author because I witnessed this on 2 different levels. First, most of my customers at the pharmacy were paying out the ### for Nexium and still complained of symptoms while on it for months.
Also, my husband took (in order) Prevacid, Nexium, the generic for Nexium Omeprazole, and lastly Prilosec.
He is to the point where he only uses Prilosec minimally. We save TONS of money considering he also is uninsured at the moment (another issue I won't get into). He has also changed dieting habits, watches the timing that he eats/drinks before bed and early in the morning (usually the worst for acid reflux flairs up because you are laying down and raising up).
But I promise if you go to a doctor and say "I am having acid reflux" and tell of the symptoms he will write you Nexium (not something generic or even suggest Prilosec first). You will get to your pharmacy thinking "Hey I have insurance", they fill it and you start to pay and it is 128.95. You freak out and scream "BUT I HAVE INSURANCE!" and the technician will say "Sorry but your insurance will not pay for this unless you first try prilosec, generic omeprazole and the doctor documents that none of these things work for you."
The problem is that most of these customers (I had tons in situations like this) would go back to the doctor or call and ask why he didn't just recommed Prilosec or write for the generic because even paying cash it was 10 times cheaper. The doctor would almost always tell them they NEEDED Nexium and not to try prilosec. They would also tell the patient that the generic was risky because you might not be on the same brand as pharmacies switch often.
(This is true for some drugs, i.e. cancer drugs, insulins, heart medications, REALLY IMPORTANT medications) But for an acid reflux medication, it's got the same basic ingredient. And if a patient wanted a particular brand of generic, the pharmacist can also put in a request with the wholesaler and try to demand it for a patient. Also, they can check with other local pharmacies and locate it, if they are really a good pharmacist.
Just a rant, but it was my experience with this Nexium/Prilosec battle going on between insurance and patients.
Some people do need something more than prilosec, like for a hernia or ulcer. But most doctors know that Nexium and Prilosec have the same basic ingredient-omeprazole-just in different strengths. In addition to a generic being available. A patient could still save money by for instance doubling prilosec as opposed to being stuck with $120+\- Nexium or Prevacid or Zegerid while accomplishing the same thing.
It's all about money baby! Sell those pills, get a reward check later.