To treat or not to treat, that really is not the question

Few patients come to physicians with the expectation that they won't be treated. They have a problem and expect that a good physician will provide some sort of relief, which to them often means a drug or treatment. While physicians may often question the benefits of a particular therapy, how to decide whether one therapy is as good as another is a challenge. From a researcher's perspective, the question is: How do you know one treatment is as good as another? Consider the situation in which payers say they will only pay for a generic drug. How do you-and, in fact, they-know that the generic drug is really as good as the brand name drug? Mostly likely the generic drug costs considerably less than the brand name drug, so one might be suspicious that the payer is merely trying to maximize profit. The payer is trying to reduce costs but relies on the fact that the US Food and Drug Administration (FDA) has provided approval for this generic drug; therefore, it must be as good as the brand name drug.