Part of the issue is that insurance companies often “reset” this process. I know a friend with really hyper specific health conditions that requires a fairly expensive, experimental treatment. They need this because they’ve tried everything already. But sometimes the insurance company seems to forget that they already tried everything, and refuses to pay and tries to get them to go through it all over again, a process which destroys their ability to function and leaves them seriously disabled for months at a time.

This also happens if the employer switches insurance.

So no it isn’t as innocent not as simple as saving costs for generics. This makes sense for the first time the patient seeks treatment. This doesn’t make sense if the patient already has a treatment plan that works and the insurance company decides they want to do the whole pony show again, fucking in peoples life for months.

Speaking of genetics, screening for the genetic profile of variable liver enzymes for known mutations and their associated drug interactions could actually save on the shotgun approach to dispensing medicines.

The problem is, you won't be able to hammer down the health of the patient to the lowest cost option, only the most effective.

My bad. You are correct. I misspoke. What I meant to say that at times generics (and similar drugs, but not generics) won't work as well as the original drug. Not always, but sometimes they just aren't effective in certain circumstances. The doctor may know this, but can't immediately prescribe what is effective in the name of "saving money"

> Generics are well known to be effective, and exceptions are unusual.

A [relatively] well known exception is anticonvulsants. My younger brother paid for that with his life. I hope the FDA figures out how to properly evaluate generic equivalence.