Doctors brace for prescription drug policy changes

"If [the patient] does as well on the generic as they do on the brand-name, then they don't need to go back on the expensive drug," she said.

Zivkovich has a different take on the process as he said waiting for a patient to fail on the two statins and Lipitor, which is on a preferred basis, could take up to nine months. It is a wait, he said, that could cost the patient his or her life.

"What if [the patient] dies during those nine months," he said. "The insurance company wouldn't back me up on that. Whether the insurance company covers [Crestor] or not, I can't use the excuse that the insurance company wouldn't cover it in the court of law."

While Zivkovich says the new policy is designed to bury doctors in paperwork in order to force them to take the easy route and just prescribe the generic drugs, he said refuses to follow those guidelines and will continue to prescribe the brand-name drugs.

"When I do prescribe generics, I tell my patients to go to Wal-Mart because they have a cash plan," he said. "Because they pay with cash, it doesn't get submitted to the insurance company, so it costs less."

Another component of the change in CDPHP's policy is that they are offering doctors $50 per phone call in explaining the new policy changes. Staff said the money is meant to cover the costs of pulling a patient's chart, reviewing it to see if a generic brand would be adequate and making up for the time it took for the physician to make the call.

"In a 15-minute dialogue you could explain the rationale, where to go from here and what monitoring needs to be done," she said. "It's making honest doctors who would have to absorb the cost of that not have to make the patient come in."

Zivkovich sees the money as a bribe.

"This needs someone with a lot of money to hire a lawyer to challenge these policies," he said. "I hate insurance companies. I wish they'd all go away."


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