I just read an article in the NYT about new incentive programs which pay people in order to take their prescription medication; the reasoning behind the plan is that up to a fourth of Americans who have prescriptions never bother to fill their prescriptions, but would take their medicine if there was a financial incentive involved. A Philadelphia program cited in the article gives patients who fill a prescription for a certain anti-blood clotting medication the chance to win cash for each day they take the medicine.

According to the NYT article, this program and others like it are being touted by both doctors and the pharmaceutical industry as win-win scenarios.  The patients in the Philadelphia program tended to view the program as a lottery-type game and there was a much higher level of compliance among the patients- the doctors believed that the program was responsible for saving many lives.

Non-compliance with medication can be a huge factor in repeated instances of illness- patients with mental health issues are possibly the largest group who fail to  comply with their medication regimes. In my opinion, many people with mental health issues could benefit from a payment program to ensure that they are not repeat patients in the mental hospital. One program mentioned in the article pays patients $22 directly for taking their medication (compliance can presumably found through the patient’s blood levels) and is also touted as a success.

My fear about these kinds of programs is that there are too many negative side-effects from a lot of medication and that much of the medication prescribed here may be unnecessary. Often, older patients start taking multiple prescriptions whose sole purpose is primarily just to deal with the side effects of other medications than the patient may happen to be taking.

While programs like these may benefit some patients, the programs also scream of too much influence by Big Pharma. There is no doubt in my mind  that the drug companies are the direct beneficiaries of patients who are dependent on their products. In addition, it is unclear who exactly is paying for the programs which benefit the pharmaceutical industry.

Others are claiming that the patients who do not comply initially with their medication are getting more financial incentives than the patients who do, which is unfair. To me, this is a little similar to a program I heard of involving at-risk students who were paid money to go to school, while their classmates were not.