In my country, general practitioners can only prescribe a limited number of drugs and specialist visits a month, so as not to overwhelm the healthcare system. It's their moral choice to deem a person sick enough for a certain course of action.

Whatever pill the doctor writes me up, I always end up asking the apothecary or looking up online the cheapest substitute. This is how the elderly here cope, they can barely pay bills, let alone choose which pills to skip. I've personally not had any problems with big pharma substitutes so far.