irreverend:

Last week I went to see a dermatologist about a rash on my arm. He sent me home with a prescription for this name-brand steroid cream, a small tube of which costs $58.

I probably would have filled it and maybe asked the pharmacist if there was a generic, but my husband (an MD who is deeply skeptical of all things pharmaceutical) saw the prescription and said, “Why on earth would he prescribe you that?”

He looked it up on his Pocket Pharmacopoeia app and found a similar drug (different steroid, same potency rating) that costs $10. It is older. It is not under patent. It doesn’t have drug reps who visit doctors’ offices and give them nifty little pre-printed prescription stickers so they don’t have write out those tricky drug names.

He also saw that there is a generic form of the drug I was prescribed, but it is manufactured by the same company that makes the name brand and sells for roughly the same price. Sneaky move, Big Pharma.

I called the dermatologist and asked if the cheaper drug was a reasonable alternative. “Yeah, okay, that will probably work.” Then why did you prescribe the more expensive one? “It’s … um … it’s just what we prescribe.”

It’s safe to assume that drug reps make regular visits to his office, buy lunch for his staff (which makes his employees happy and costs him nothing), give him free samples and those pre-printed Rx stickers, track the number of prescriptions he writes for their products, and reward him accordingly.

Needless to say, I’ll be taking my itchy appendages elsewhere next time—preferably to a doctor who subscribes to No Free Lunch, though there aren’t many in my area. As health care consumers, what else can we do? Ask questions when we’re handed a prescription, I guess. And get to know a knowledgeable pharmacist or someone who knows their way around a pharmacology app.

This isn’t to say all doctors are jerks (I like to think I married one of the good ones). It’s just maddening that so many professionals we trust with our health are more interested in dealing than healing.