Newsletter Vol.32, no. 32
PMA NEWSLETTER - 5 - August 20, 1990 "PMA appeared twice before the panel and many of its recommendations were subsequently incorporated in the committee's final report." 84% OF MDs SUPPORT LAWS BANNING THERAPEUTIC INTERCHANGE, GALLUP FINDS More than three-quarters of American physicians would outlaw therapeutic alternates -- routine use of only the cheapest drug within a therapeutic class, the Gallup Organization reports. Such interchange is the keystone of S 2605, Senator David Pryor's Medicaid drug plan. Gallup's recent survey for the Oregon Medical Association assessed physician attitudes towards a number of managed-care issues. Interviewers found 70% of US physicians "strongly support" legislation prohibiting therapeutic drug interchange -- the ultimate in restricted formularies -- another 14% "support" such laws. Five percent oppose this legislation; 7% more "strongly oppose" it. Only 3% were unsure. Little wonder for the strong feeling. Physicians reported grave effects of even restricted drug formularies. Nine cited deaths; that's only 2% of the total Gallup sample, but many MDs cited serious problems: 114 (28%) reported lessened therapeutic response; 98 reported therapeutic failure (24%); followed by 51 reports of allergic reactions/side effects, 50 mentions of poor/loss of blood pressure, and sizable numbers of heart failure, convulsions, etc. Gallup interviewed 500 randomly selected high-prescribers -- cardiologists, general practitioners, internists -- nationwide, another 200 in Oregon, by telephone last January. Two-thirds of the national sample; 3/4 of the Oregon physicians, treated HMO, PPO and other managed care plan patients. Virtually all treated Medicaid patients. Yet the confidential, preliminary Gallup report shows that these MDs oppose formularies, prior authorization and especially therapeutic interchange -- even within health plans: THERAPEUTIC DRUG INTERCHANGE: "Very large majorities strongly disapprove of this policy as applied in the managed care setting...Fully 87% of the physicians with HMO/PPO patients nationwide...report their largest managed care plan does not use therapeutic drug interchange." GENERIC SUBSTITUTION: "Data show...strong disapproval of mandatory generic substitution policies in managed care plans (nationally, 23% approve vs 74% disapprove)." STEP CARE (defined as "A policy that requires doctors to prescribe drugs in a fixed order. Usually lower-priced drugs are prescribed first and more expensive drugs are reserved for use at a later treatment stage."): "Very strong disapproval of step care protocols in HMOs/PPOs; only 10% of US physicians approve of these policies...just 3% of MDs nationwide report that the managed care plan which provides them with the most patients uses a step care protocol approach to drug prescribing." FORMULARIES: "Nationally, a solid majority of physicians disapprove of formularies by a margin of 58% to 35%...20% of US physicians with HMO/PPO patients report that their largest managed care plan uses a formulary." PRIOR AUTHORIZATION ("requires physicians to get approval to prescribe certain drugs each time they feel it necessary to do so"): "Data show
About this Item
- Title
- Newsletter Vol.32, no. 32
- Author
- Pharmaceutical Research and Manufacturers of America
- Canvas
- Page 5
- Publication
- Pharmaceutical Manufacturers Association
- 1990-08-20
- Subject terms
- newsletters
- Series/Folder Title
- Marketplace > Press releases, reports, and newsletters
- Item type:
- newsletters
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- Jon Cohen AIDS Research Collection
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https://name.umdl.umich.edu/5571095.0504.023
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"Newsletter Vol.32, no. 32." In the digital collection Jon Cohen AIDS Research Collection. https://name.umdl.umich.edu/5571095.0504.023. University of Michigan Library Digital Collections. Accessed June 11, 2025.