Doctors and drug companies

I am pretty sure that my GI doesn't get anything for prescribing one medication over another. She's always open to giving me whichever I ask for. I haven't tried Apriso, Asacol is one of the older and more well-known medications. I don't think either is considered better, they are just different and one may work better for one person than another. If neither worked for you, there are others you can try. What did the 3rd doctor offer you?

I don't think they get kickbacks per say but my exwife was a nurse working in doctor's offices and it was quite common for drug companies and others to buy the whole office lunch. There's not many days she had to worry about lunch because somebody somewhere bought it almost every day. And, that's why they get the free samples. It's not exactly out of the kindness of their hearts. The drug companies give a bunch of free samples to the doctor's office and then the doctor then gives free samples to the patients. Well, the doctor isn't going to give a bunch of free samples of Apriso to one of his patients and then turn around and prescribe Asacol. Some doctors are above this but that's kind of how the system works.

Here is a perfect example from the Washington Post newspaper, a multiple sclerosis patient loses trust in her neurologist because of his ties to drug companies:
washingtonpost

Doctors absolutely make money off prescribing drugs! Some are bigger money makers than others. I would still like to think that a good doctor will always have the patients best interests at heart when suggesting medications and not thinking about padding his/her wallet first.

A while back we did a thread on aggressive marketing by drug companies, and Eva Lou, who works in a clinic, described all the merchandise stamped with these companies' logos that their sales reps would bring to distribute to personnel at her facility. It was both appalling & hilarious because some of the stuff was so tacky. When a gastro gives an IBD patient free Rx samples, though, it doesn't necessarily mean that the doctor is "pushing" a particular drug because he/she is invested in the manufacturer! These meds mostly are very expensive to buy & may not work or can cause allergies/side effects-- so the gastro may actually be saving the patient needless expense by handing them a trial Rx sample. I was thrilled when mine gave me Colazal samples in convenient purse-size bottles at the outset of my treatment! It turned into an absolute blessing because the med helped me more than any of the older 5-ASA meds which I had to pay for from the very start. / Old Hat (32 yrs with left-sided UC; presently in remission taking brandname Colazal)

Some doctors get plain old monetary bribes. Most get "perks", like the aforementioned free food or trips to boondoggles (like ski vacations that are supposed to me medical conferences). It's a scam. Our medical system, as good as it may be at times, sucks big time in so many ways.

There's alot that can be going on to make one doc push a particular pill/ medication over another. I've never used Asipro but I can comment on Lialda vs. Asacol

When they started as a GI - Asacol has been around forever and that may be their tried and true default

Considerations about patient compliance - Lialda you take once a day (4 pills max) while you need to take Asacol 3x's a day (3 pills each time max?)

Considerations about patient financial state - I don't think Lialda has a generic yet, so Asacol might be the better option financially for some people.

Free samples on hand - give these a try then get a script

State of your condition - I've heard that some of these might be better than others in different parts of the digestive tract

Convenience (Humira) versus record (Remicade) - Humira is much more convenient to take. Remicade has a better track record. It depends on what your GI values more.

As someone else mentioned, I don't think drug companies can give docs incentives anymore (aside from samples and food). My mom works in a doctor's office and I remember several years ago (around 2009) talking about how they would no longer be overwhelmed with free pens!

Some docs will also get frustrated when you don't follow their instructions (i.e. Get the Remicade!) or will get frustrated when they see a patient in a really poor state not taking the medication that the doctor thinks is the absolute best option to get a person better.