TV sweeps period contrived controversy

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We’re in the middle of the November TV ratings/sweeps period. TV stations at these times often suddenly like to show a great interest in health care stories because their consultants tell them that viewers want health care news. (Why they don’t give it this attention the rest of the year is unknown.) But health care is not a topic that you can suddenly dust off and act like you understand it. There must be a daily commitment to the issues and to understanding what’s important for consumers to understand.

Last week, WCCO, a top-rated station in a major market (Minneapolis) delivered a story with a tone that suggested that the station felt it had uncovered a major issue: that health plans were giving doctors a financial incentive to prescribe a certain percentage of generic drugs.

Here’s the full text of the story.

It never explained why generic drugs are important in the nation’s cost control effort (if there is one).

It never interviewed a physician about his/her practice of prescribing generic drugs.

It quickly threw out a line that said “This practice is known as ‘pay for performance’ ??? – never explaining anything about the much broader definition of “pay for performance??? or why it is being implemented in settings across the country or why many health policy experts think it is a wise move.

It profiled a patient who didn’t match the contrived controversy the station was presenting. The patient said he tried generic drugs but he suffered side effects, so his doctor prescribed a brand name drug. So what’s the story? No one forced anyone to do anything. And the patient says he’s now happy. Controversy? More like viewer confusion!

For some reason, WCCO only mentioned two health plans that use the generic incentives but there are others who do this that weren’t named.

Anyone who knows me knows I’m no apologist for the health insurance industry, but I felt compelled to get health plans’ reaction to this story.

Spokesman Greg Bury of Medica (which was named) wrote me:

The piece did little to educate consumers about generic drugs and their role in treatments, the practice of medicine and efforts to control health care costs.

As it was pointed out to WCCO, the drugs qualifying for the incentive have the exact same active ingredients as their brand-name counterparts. The FDA ensures that they are the same. Generic drugs started out as brand name drugs; therefore, one could argue that they are a safer starting point for treatment thana brand name drug because of their track record for safety and efficacy.

Generic drugs help control the rising cost of health care. They typically cost 80-90% less than their brand name counterparts. These savings are passed along to patients because their lowest copay level typically applies. The cost structure of generics also helps slow the rise of health care premiums that are paid by plan sponsors – employers for most people – and consumers themselves.

Overall, the story is a missed opportunity to point out the value of generic drugs in the health care system. One has to wonder if WCCO is interested in helping its viewers understand the system and how they can benefit from it or if they are more interested in stirring controversy to boost ratings. We are in a sweeps period, aren’t we?

Medical director Dr. Pat Courneya of HealthPartners (also mentioned in the story) wrote me:

The story sets up a false dichotomy, suggesting that brand name drugs are inherently superior in some way to generics. Despite decades of effort by the pharmaceutical industry to sow doubt about the safety and effectiveness of generic drugs, the evidence shows they are both safe and effective. They now account for the great majority of the drugs prescribed to patients. Doctors write these prescriptions despite the billions of dollars spent to market brand name alternatives. They do not do so disregarding the best interests of their patients.

Primary care doctors (I am a practicing Family Physician) would be insulted by the implication that we could be expected to “prescribe a certain number, percentage of generics, whether it’s in the best interest of the patient or not.” If I were told that, I would immediately protest and possibly contact an attorney. I have never been told to do anything whether it was in the interest of the patient or not, and I hope anyone who is would speak up.

Individual doctors do not get bonuses. Our financial rewards go to the medical groups – not individuals. Some medical groups use the money to further improve care for patients. For example one medical group used HealthPartners bonus to purchase a glucometer for their clinic so that diabetes patients could test their blood sugar and have the results in the exam room. The group was motivated to improve care for diabetes patients which is another measure in pay for performance.

If WCCO – or any news organization – invested in a full-time health care journalist – someone who fully developed health care reform issues such as generic substitution and “pay for performance” in its entirety – such pieces of naive, incomplete, pseudo-investigative journalism would not see the light of day. And the viewing audience would be better off.

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