Most Americans want their doctor to make the call in determining which prescription medication they take for a certain condition, according to an AstraZeneca-sponsored survey.

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Poll: Doctors should get final say on Rx

December 5th, 2011

WILMINGTON, Del. – Most Americans want their doctor to make the call in determining which prescription medication they take for a certain condition, according to an AstraZeneca-sponsored survey.

AstraZeneca said Monday that the online poll of 1,000 U.S. adults, conducted by StrategyOne, revealed that 84% of respondents think their physician should be the main decision maker in deciding which medications they should take.

What's more, 87% patients surveyed want to be told at the pharmacy if they aren't getting their originally prescribed medication, the study found.

AstraZeneca noted that the survey highlights concerns about therapeutic substitution, in which a person's health insurer may contact the patient, his or her doctor, or the pharmacist and ask that the patient be changed from the currently prescribed medication to a different drug in the same therapeutic category.

"Therapeutic substitution can be a good thing because it could reduce costs, but there can be differences among medications," Dr. Philip deVane, executive director of clinical development at AstraZeneca, said in a statement. "It's important that patients be involved with health care decisions and be informed about the medication they are prescribed and that they are receiving at the pharmacy. Ultimately, the patient's physician should make the final determination regarding what medication is best for the patient."

AstraZeneca made the following recommendations to patients to help them ensure they get the medication they have been prescribed:

• If applicable, make sure the doctor writes "medically necessary," "may not substitute" or "dispense as written" (DAW) on the prescription

• Before leaving the doctor's office, ensure you understand why the doctor has prescribed that specific medication.

• Ask your pharmacist questions to be sure you are getting the medicine you have been prescribed, and check before you leave the pharmacy.

• Be familiar with what your medication looks like.

• Request that your doctor and/or regular pharmacist puts a note in your electronic record explaining that you take a certain medication and that it shouldn't be changed.

• Tell your doctor and/or check with your insurance plan if your medication is changed without doctor/patient communication.

The drug maker reported that, according to the nonprofit advocacy group the National Consumers League, therapeutic substitution often occurs with statin drugs, which help lower cholesterol levels.

However, AstraZeneca noted that no two drugs in one therapeutic class are exactly the same and not all have generic equivalents. For example, the company said its drug Crestor (rosuvastatin calcium) has no generic form, and a doctor may recommend that medication when diet and exercise alone aren't enough to reduce cholesterol levels as needed.

The survey findings were announced just days after the launch of the first generic versions of Lipitor (atorvastatin calcium), Pfizer's blockbuster cholesterol-lowering medication, by Ranbaxy Laboratories and Watson Pharmaceuticals. In May, Teva Pharmaceuticals USA is slated to ship its own Lipitor generic under an agreement with Ranbaxy.

An online report by Time last month said the rollout of low-cost Lipitor generics could impact demand for Crestor. The Time article cited a study published by the New England Journal of Medicine, which found that Lipitor and Crestor were similarly effective in reducing cholesterol, although Crestor patients did better on some measures.