> Yes, a new drug might only be a small tweak of an existing drug, but all humans aren't the same. A patient may not be able to take an older version, but the me-too works for them. That has added value.
Indeed this is true, individual patients will respond differently, and inexplicably, to medications in the same class (e.g., Prozac vs. Zoloft). Having these choices is very useful.
However there are considerations beyond pharmacology that reduce the value of these choices. Problems arise because of non-clinical factors, particularly what rules of insurers allow. Formularies have become quite restrictive in many environments making it difficult to make use of the range of alternatives that are theoretically available.
In the last 10 years several new antidepressants have been developed, approved and marketed. That doesn't mean that patients can easily get these drugs even if patients have failed to benefit with older options. Insurers erect barriers like stiff co-payments, or complicated prior authorization procedures as effective impediments.
Consequently what good are new medications if they can't reach the people who need them? There's a strong disincentive to try to use these drugs and I think it's likely manufacturers would have less reason to develop them if they can't sell them.
So doctors would like to be able to prescribe what would work better, but that's frequently not practical. I'd add that doctors are not so easily "conned" into prescribing an agent just because companies and reps are promoting it. Quite to the contrary, making up one's own mind based on the merits and ignoring the sales pitch is the reality.
Indeed this is true, individual patients will respond differently, and inexplicably, to medications in the same class (e.g., Prozac vs. Zoloft). Having these choices is very useful.
However there are considerations beyond pharmacology that reduce the value of these choices. Problems arise because of non-clinical factors, particularly what rules of insurers allow. Formularies have become quite restrictive in many environments making it difficult to make use of the range of alternatives that are theoretically available.
In the last 10 years several new antidepressants have been developed, approved and marketed. That doesn't mean that patients can easily get these drugs even if patients have failed to benefit with older options. Insurers erect barriers like stiff co-payments, or complicated prior authorization procedures as effective impediments.
Consequently what good are new medications if they can't reach the people who need them? There's a strong disincentive to try to use these drugs and I think it's likely manufacturers would have less reason to develop them if they can't sell them.
So doctors would like to be able to prescribe what would work better, but that's frequently not practical. I'd add that doctors are not so easily "conned" into prescribing an agent just because companies and reps are promoting it. Quite to the contrary, making up one's own mind based on the merits and ignoring the sales pitch is the reality.