Allergic to Generics

  1. Troyen A. Brennan, MD; and
  2. Thomas H. Lee, MD
  1. From Brigham and Women's Hospital, Partners Community Healthcare, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts.

    Abstract

    A 69-year-old woman with several medical problems believes that she is allergic to generic medications. She frequently conflicts with her long-time primary care physician, who, as required by the patient's insurance coverage, refuses to prescribe brand-name drugs when generic alternatives are available. This conflict intensifies to a crisis when the patient develops life-threatening problems and still will not take prescribed generic medications. The presentation of this real case is accompanied by a discussion of the ethical dilemmas of the patient's physician, who must weigh the interests of a patient who clings to beliefs that the physician thinks are unfounded against the interests of a just rationing program and the broader population it serves.

    Article and Author Information

    • Potential Financial Conflicts of Interest: None disclosed.

    • Requests for Single Reprints: Troyen A. Brennan, MD, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; e-mail, tabrennan{at}partners.org.

    • Current Author Addresses: Dr. Brennan: Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

    • Dr. Lee: Partners Community Healthcare, Inc., Prudential Tower, 11th Floor, 800 Boylston Street, Boston, MA 02199.

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