Off to rounds, I will rant later this morning about this article – HIGH PRICES. This article, written by one of my favorite writers – Malcolm Gladwell – gives an interesting overview of why we are spending so much on medications.

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Back from rounds! Everyone is doing well.

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The core problem in bringing drug spending under control, in other words, is persuading the users and buyers and prescribers of drugs to behave rationally, and the reason we’re in the mess we’re in is that, so far, we simply haven’t done a very good job of that. “The sensitivity on the part of employers is turned up pretty high on this,” Robert Nease, who heads applied decision analysis for one of the nation’s largest P.B.M.s, the St. Louis-based Express Scripts, says. “This is not an issue about how to cut costs without affecting quality. We know how to do that. We know that generics work as well as brands. We know that there are proven step therapies. The problem is that we haven’t communicated to members that we aren’t cheating them.”

This article does a very nice job of providing texture to the problem of drug expenditures. While “big pharma” is greedy (after all they are for-profit companies), they cannot make physicians prescribe drugs. We must become more intelligent about prescribing. We must resist requests for Nexium and Celebrex – unless they are clearly indicated.

I object to direct to consumer advertising because it makes our job more difficult, but we must still do a good job. We do need more easily researched sources for drug information (efficacy and price). The data are available but often difficult to decipher.

We in academe should do a better job at packaging and presenting the information to practicing physicians.

But this rant pales in comparison to the article. Gladwell rights brilliantly. He will make you think and reconsider all of your assumptions about drug costs. So if you have not read the article please scroll up and go clickety click!