Dad would have had to pay about $40K for Esbriet (for IPF a lung disease), and $1,700 per dose once every two weeks for Humira. And other drugs too like morphine, prednisone, laxatives and so on. But basically it ended up being almost $0.
Doctors do and can help a lot with drug costs. At least here in Canada the US who knows doctors probably get more in drug sales than anything.
Just like there should not be an expectation for the doctor knowing and telling you there is a coupon for vegetables at the grocery store if they tell you to eat more vegetables. If the doctor does know it, that is a bonus.
If a doctor in the US wants to be great at their job, they can’t ignore the financial component of their work — obviously some exceptions here like the doctors who work fee-for-service on the rich.
If a doctor recommends a treatment that the patient can't afford, and the patient doesn't discover that until days later at the pharmacy, that likely results in wasted time for all involved. The patient has to meet with the doctor again to discuss cheaper alternatives. Or forgo treatment, and risk more significant health problems, which lead to more cost in the future.
My dermatologist almost always discusses the costs of treatments. One example - a topical cream is available as name-brand or generic. The generic is formulated at a higher strength but costs less. So, I can pay more for a gentler, slower treatment. Or save money, but get a harsher treatment. Both work fine, but after selecting the harsh generic once, I won't do that again - it works faster, but the side-effects were miserable.
If the patient has a weird formulary or a high deductible, that's on them to understand.
As it turned out, my insurance wouldn't cover it at all, because they wanted me to try a cheaper, older medicine that had a much worse list of potential side effects.
If it hadn't been for my doctor, I wouldn't have known about the aid program or to enroll in it (technically, it was through a separate, non-profit legal entity, but it still has the manufacturs name in it).
The best doctors understand that a patient is an entire person, not just some specific problem or disease. Sometimes that means considering factors in their life other than the obvious direct medical causes of their problems. Sometimes that might include the availability of treatments, based on cost or location.
https://en.wikipedia.org/wiki/H._Jack_Geiger
https://www.nytimes.com/2020/12/28/health/h-jack-geiger-dead...
> Sometimes that might include the availability of treatments
this is about coupons. your doctor won't help you write your resume, even if they could and it would help you afford medicine in the future. That isn't their domain.
Doctors are specialists.
Geiger believed that the greatest threat to public health of his day was nuclear war, so he founded an organization (Physicians for Social Responsibility) to try to stop it, because he thought that would be more effective than waiting for the bombs to fall and trying to treat the victims.
You can disagree with his assessment, or the efficacy of his methods, but it's pretty unfair to dismiss them as "nonsense".
not exactly the same as founding an ethics foundation in their own field
> who realize that the domain of "health" is broad and encompasses things that aren't germs.
what things? mental health? still medical, and still deferred to specialists.
Coupon hunting? Resume writing? not medicine.
ok.
> This is not about taxes
why not? Maybe you are missing the point I am making, but then you are selectively not responding to things I already wrote, that I think I outlined pretty clearly in the last post.
what is out of scope here? Where does it end? You suggest a doctor should do more somehow, but doesn't say where the limit is, if any. the point is your own arguments seem to apply to taxes, resumes, coupons etc as much as anything else more medically related.
I think it's pretty rich complaining about me being "obtuse", when you fail to address the main point of my posts.
The whole pharmacy coupon thing is an almost entirely American phenomenon. US and NZ are the only countries that allow direct-to-consumer marketing of drugs in the first place.
I've had very serious pushes from doctors to get medication like this.. the doctor was absolutely aware of the economics involved, including what was good for him. I thought I was not at a doctor's office, but dealing with a used car salesman.
Disclosure laws curb the worst historical excesses, and there are good arguments in favor of further restrictions. Good reps serve an educational purpose, and when the medicines available to treat a disease have evolved dramatically, that education can be necessary.
For example, there are still primary care physicians who just go to sulfa drugs then insulin after metformin. There are much better medicines that actually protect other organ systems too! But they didn't learn about them in med school, and it takes some consistent nudging to get them to break the old prescribing habits.
1) you're guilt tripping them
2) you're giving them cover if they get asked about it
It's much nicer to work at a grocery store pharmacy than a dedicated retail chain because of this