title: Allergic to generics.
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.
authors.affiliation: Brigham and Women's Hospital, Partners Community Healthcare, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts 02115, USA. tabrennan@partners.org
authors.forename: Troyen A
authors.initials: TA
authors.lastname: Brennan
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Lee
mesh_terms: D000368:Aged; D016568:Drugs, Generic / Q000009:adverse effects / Q000191:economics; D004992:Ethics, Medical; D005239:Fear; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D008484:Medicaid / Q000191:economics; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D010820:Physicians / Q000941:ethics* / Q000523:psychology; D016312:Treatment Refusal; D014481:United States
chemical_list: D016568:Drugs, Generic