Lucentis, a brand name drug that treats macular degeneration, is a good example of the way the U.S. health care system is biased against generic drugs. The NYT reports that Lucentis is made by Genetech, the same company that makes a generic drug called Avastin. Several studies have shown Avastin is as effective as Lucentis at treating macular degeneration, but Lucentis nevertheless became a popular drug; billings for it now cost the federal government about one billion dollars annually. The NYT piece suggests that a factor in the drug’s rise is over-prescription of the drug by doctors who are paid consultants for Genetech:
Now, a new federal database shows that many of the doctors who were the top billers for Lucentis were also among the highest-paid consultants for Genentech, earning thousands of dollars to help promote the drug
Half of the 20 doctors who received the most money from Genentech to promote Lucentis in 2013 were among the highest users of the drug in 2012, billing for higher amounts of Lucentis than 75 percent of their peers. The figures were compiled from two federal databases that covered different periods, and it is not known whether or how much Genentech paid the doctors in 2012.
The 20 doctors earned $8,500 to $37,000 over five months in 2013, payments that included consulting and speaking fees as well as travel expenses and meals. Genentech says it has an annual cap of $50,000 a doctor for speaking fees.
Doctors claim that Lucentis is safer than Avastin, but the story quotes a review of nine different clinical trials that indicate the generic drug does not increase deaths or serious side-effects. If doctors are prescribing more expensive brand name drugs than is necessary, that’s one more reason for patients to have more an incentive to be involved in their own care. Studies show that patients do opt for cheaper procedures over more expensive ones when both are about equally as expensive—even for their children. Presumably the same would hold for generic and brand name drugs. The best way to make sure doctors aren’t padding profits by drugs like Lucentis is to empower consumers.