Rationale?

CP: We asked the question many posts ago about "what happened to yesterday?".  It was about the hot new drug to hit the market and how everyone forgot yesterday. What did you use yesterday that this new drug replaced? Wasn't it the "IT" drug at some point? Until today?

ME: Right. And we asked why that one is no longer good. 

MICE ELF: We're looking at you dermatologists. 

ME: Among others. Those who graduate today (pharmacists in particular) know today's market as it is. Those of us who graduated in another decade, or century perhaps, have a different view of the market. 

CP: THEN-we were happy to hit 40% generic dispensing. 

ME: NOW, it's a bit different. 

MICE ELF: Where were you going with this?

CP: People and their idiosyncrasies; specifically as it pertains to generics. 

ME: Ok. As in why the hangup when switching?

MICE ELF: Or the brand exclusivity rights and insurances not covering lower-cost alternatives that have been on the market for years?

CP: Yes and yes. But mostly this:

CP: Welcome to CP's Concoctions and Pessaries. What brings you in today?

Stay With It Until I Call Her: Picking up my prescriptions. 

CP: Ok. On the Dexilant, I see that it is on a manufacturer backorder, like half of the rest of my stock. You've been receiving the brand for a while, even though the generic has been available. I can readily order the generic for you and it is a few dollars less. 

SWITCH: I'm not sure. 

CP: About what? The words I used? I was pretty clear. Generic available; Brand not. You wish to continue taking this, you switch. Pretty succinct. 

SWITCH: No. Not sure I should switch to the generic. 

CP: What's the uncertainty? 

SWITCH: I should probably ask my provider first. 

CP: Ask them what?

SWITCH: If it's okay to switch. 

CP: Trust me, they don't care. 

SWITCH: Well I need to check with them first. 

CP: You have been taking amlodipine, hydrochlorothiazide, losartan, atorvastatin, and levothyroxine for the last 10 years. 

SWITCH: Yeah, so?

CP: So they are all generic medications. They may have been generic since the time you started them, or shortly thereafter, but they are all generics. I've been working long enough to remember when these were all brand only; except the HCTZ, that predates even me. What makes this one different?

SWITCH: <shrugs> I just have to ask them. 

CP: That's not an answer. If you had started on this medication today, you would only know it as generic, same as all your others. Those brands were so yesterday. Choose, or I shall choose for you. 

“Choose a life. Choose a job. Choose a career. Choose a family. Choose a fucking big television. Choose washing machines, cars, compact disc players and electrical tin openers...  choose your future. Choose life... But why would I want to do a thing like that?”

#IfYouChooseNotToDecideYouStillHaveMadeAChoice