Thx for the response, wondering what UHG's potential motivations may be. I used to work in the medical billing industry, and UHG had a very poor reputation (among major insurers) with the two healthcare management consultants I worked closely with.
(edit: UHC-->UHG)
The last paragraph in the article gets to the point:
“There’s only one reason why they’re requiring you to use a more expensive product,” Mr. Frankil said. “Because somewhere down the road, somebody is earning more money.”
The brand-name maker would like the generic market to dry up, so it may be as simple as the brand-name maker selling its product at a reduced price on condition that the insurer cuts off the generics. Given that some patients demand brand-name drugs and some doctors acquiesce, this may be cheaper for the insurer.
My doctor has a straightforward attitude - referring to patients who demand brand-name drugs "I told them 'I take generics. My kids take generics. If you won't take generics, find another doctor!'" (that was before the practice described here emerged. I am sure he has something to say about it...)
I wonder if this is an end-run around my hands-down favorite part of the ACA, the hard limit on the "Medical Loss Ratio" (MLR). Insurance companies must spend at least ~80% (the number varies by plan type, but call it 80%) of premiums on medical expenses, and if they don't, that's when you get those refund checks in the mail. (In the 90's, you had a few insurance plans with >90% MLRs, but by the early 2000's the average had declined to 70%, and you had some companies selling plans to college kids with a 10% MLR.)
This is overall good, because insurance is one of the few industries that benefits from monopoly conditions (bigger risk pools are better), so you want a hard cap on how much money the monopolies can extract. But maybe demanding non-generics is a way to increase "medical losses", which in turn is a way to increase their permissible profits?
Interesting, or a similar phenomenon to situations where in order to maximize deductions you might want to increase charitable contributions, better to give the money to a friend non-profit than Uncle Sam
Generic neurological drugs are not reliably consistent. The allowed variations and additives can and do play havoc in some people. Even something so simple as coloring can be a problem.
