Research Position—Dan Primavera

Prozac: Caucasians Only

As someone who comes from a family that has a history of people suffering from depression, a topic involving the anti-depressant, Prozac, being a “white drug” was automatically an eye catching topic. Coming from a mostly Italian family of course indicates a family of Caucasian decent, so the fact that there has been research done in question of physicians’ prescribing practices with Prozac, specifically for Caucasians, it seemed very interesting. Being that multiple universities have done research into why Prozac is typically prescribed to Caucasians and not minorities made it even more intriguing because it sounds as if it is a problem. Also, in a sort of random relation to this topic, three family members of mine are or were prescribed to Prozac, while an adopted cousin who is African American is prescribed generic fluoxetine brand or, Prozac “that is processed and distributed without the use of the brand name Prozac” (Generic Prozac, wisegeek). Along with this connection to the drug through family, my father works for the pharmaceutical company, Bayer Healthcare, so he was able to give some input as well.

A term often used to describe the prescription drug, Prozac, is that it is referred to as a “white drug.” This term is meant to reflect upon the prescribing trends of the drug and how it is typically prescribed to Caucasian persons rather than different minority groups. Being that Prozac is a drug meant to help any person who has conditions that require its’ medicinal aid, I feel that it is ridiculous for any person to be given a drug that may not be as effective just because of their race.

Prozac has been around since 1987 and has since been one of the more profitable prescription drugs out. Also, Prozac is considered to be one of the most affective prescription anti-depressants. On top of its’ great effectiveness for treating depression, Prozac is also helpful with a few other conditions, with almost no side effects, and a fairly low chance of overdose.

Prozac is considered to be the top of the line anti-depressant seeing that “more than 33 million people in the United States are prescribed to this drug every year and the number of people prescribed to it seems to climb every year” and that it has “boomed into a billion dollar industry,” but this does not mean that these generic brand anti-depressants can not do the same job and just as affective. But, being that prozac is the most well known drug to treat depression, many would believe that they are being “short changed” when receiving the generic brand instead. Also the fact that prozac is mostly prescribed to white people should definitely raise eyebrows as to the question of whether or not our doctors are racist and not giving minority groups the proper treatment.

To clear up why Prozac being a “white drug” is in need of defining I would like to just lay out the exact medical uses of the drug. With this I would like to prove that there is no reason for it to not be prescribed to any person with conditions warranting the prescription.  The medical conditions warranting a Prozac prescription are: major depression, OCD (obsessive compulsive disorder), panic attacks, bulimia, premenstrual disorder with unhappiness, bipolar depression, posttraumatic stress disorder, anorexia nervosa, and these are not all of them (WebMD). Seeing that there are that many medical reasons to be prescribed this drug, it is very hard for one to understand how the drug is almost rationed to only white people.

There have been many medical studies that follow up on this idea that Prozac is typically not prescribed to minority groups, mostly just white people. There are some arguments for financial or insurance factors that prevent many from getting Prozac, but they do not account for enough of these cases to not consider this situation as odd (this financial/insurance argument will be addressed in my rebuttal essay). At the University of Michigan, there was a study done to address this topic and the results were not that surprising after already reading up on this subject. The study found that Hispanic persons and respectively, African Americans with depression types of disorders, were less likely to be given prescribed antidepressants. The study also stated that a white person with the same symptoms or conditions would be prescribed Prozac with relatively no problem. Michigan’s study also went into insurance problems that found people who are under the insurance of Medicaid or Medicare were also not likely to be prescribed antidepressant medications. Seeing that the study pointed out the race factors of prescribing Prozac and the insurance side of the argument makes it a great study to reference. Being that those who are recipients of Medicaid or Medicare are also unlikely to receive Prozac can sort of also be thought of as a counter because in the studies where any inquiries are made into what percentage of white people receive Prozac compared to minority groups who don’t, because maybe a high percentage of the minority groups are under those two healthcare companies.

The team carrying out this research conducted a very in depth study into Prozac being a “white drug” which spanned from 1993-2007. The researchers pulled information such as who was receiving antidepressant prescriptions, and which antidepressants they were given. Michigan’s researchers found that, “race, payment source, physician ownership status and geographical region influenced whether physicians decided to prescribe antidepressants in the first place.” The most influential findings in the above statements on whether or not Prozac is typically just prescribed to white people are, race, physician ownership status, and payment source. White people were found to be recipients of antidepressants (specifically Prozac) 1.52 more times than minority groups even if they showed the same medical conditions warranting an anit-depressant such as Prozac.

Being that Prozac is an anti depressant, and a highly effective antidepressant, there should be no reason that race should prevent any person from receiving a prescription to it. Looking at every medical condition that warrants a prescription to Prozac, and when a doctor sees those same conditions in a patient, it should be almost automatic for the patient to be prescribed Prozac (as long as their insurance and health conditions are able to cope with this type of drug).  Because many have previous conditions that may conflict with the effectiveness of receiving Prozac, it is understandable that these persons may factor into the percentage of minority groups’ people who do not get prescribed Prozac, but hopefully this is a factor that is taken out of most studies.

Antidepressants are drugs that are meant to help a person with conditions such as major depression, OCD (obsessive compulsive disorder), panic attacks, bulimia, premenstrual disorder with unhappiness, bipolar depression, posttraumatic stress disorder, and anorexia nervosa. When looking at all of these factors that could negatively harm ones health, how is it possible to deny a person of a drug that would make their life better, just because of their race?

There are no clear cut reasons that Prozac is mostly prescribed to white people but there are many factors that go into this complexity that may be the cause (although some may not be right or just). Although it would be completely ideal to have no racism in our world, it is sort of a “wet dream” if you don’t mind me saying, and being that this is something that factors into everyday life makes a large impact onto this situation. Of all people, many would at least hope that doctors would be a profession that racism would not factor into, but after looking at multiple studies, there is just no way that racism is not a cause for minorities not receiving Prozac and getting the generic brands. In a couple different studies, there were many findings that definitely indicate racism of the physicians because of the fact that some of the minority persons who ended up receiving the generic brand Prozac had no imperfections that should warrant this. These imperfections would include healthcare types that may not cover the real brand name Prozac and also health issues that may be affected negatively by the brand name pill. Seeing that these minority persons are completely eligible to receive the brand name Prozac, and are still given the generic brand, indicates racism in some parts of the physician field. This is a truly sad thing to have confirmed through this research.

On top of the racism factor into Prozac being mostly prescribed to white people, one of the few other causes for this to occur is a patients’ medical provider not allowing for the name brands pill to be prescribed. But, although this is a valid argument as to why one may not be prescribed name brand Prozac, it does not cover the large amount of people with valid medical providers who should allow for the name brand drug. The fact that there are so many conditions a patient may have that would warrant a Prozac prescription and many are still given the generic types is worrisome.  Although the generic brand Prozac is effective in what it is supposed to help within its’ patient, nothing beats the real name brand drug and there is no reason why any patient should have their rights taken away for the best treatment possible.

There are multiple arguments as to why many believe that racist physicians highly factor into this “epidemic” including the way generic brands sometimes lack in their medical aid to patients (specifically towards minorities because they are seemingly targeted to receive these prescriptions). Many generic brands are able to function just as well as the name brand Prozac, but there are many cases in which the generics are negative in their intentions. According to wisegeek, patients who receive the generic Prozac prescriptions normally do not get the medical aid that the anti-depressant is supposed to give for a longer amount of time than if they had the name brand pill, causing many doctors to increase the prescription when it is really unnecessary because it would eventually aid them. Many insurance companies actually, “specify that the Prozac prescription must be filled with the name brand and not with a generic drug” after seeing the ineffectiveness of the generic brand over some time. On top of these weary cases as to why many minorities are prescribed generic brand Prozac instead of the name brand pills, there are also many factors that cause this to be a “white drug.”

When looking at the issue of what causes Prozac to be a “white drug,” one must look at the issue from all angles. Although there are many unsettling factors that create this abnormality to occur in our medical world, there are also a few factors that benefit those who do not receive Prozac and get the generic brands. These beneficial factors into why some receive the generic Prozac brands isn’t really as investigated as the reason why many minority groups do not receive the real Prozac prescriptions, making this argument very important to consider because it is a very large influence on which prescription is written for a patient.

While addressing these issues I was able to turn to some family members for further clarification. My father, who works for the pharmaceutical company Bayer Healthcare, commented on my papers topic by saying that, “although I do not know all the statistics on who (race wise) receives a Prozac prescription, I can at least say with confidence that in most cases, a patient not receiving the name brand drug is probably due to their insurance company or plan. The name brand drugs are typically extremely expensive compared to the generics, so many insurance types will not cover the expensive name brands” (Louis Primavera, Bayer Healthcare Pharmaceuticals). Also on the topic of family being involved in this topic, of my three family members who have been prescribed an anti-depressant (my uncle is deceased but was prescribed to one), the only minority of the three has a generic Prozac prescription. My adopted cousin, Ashley, who is African American is prescribed a generic Prozac and this struck me as very surprising because her family has a very stable income, in no way has large money troubles, and the other two of my family members with an anti-depressant prescription have or had name brand Prozac. Upon speaking with Ashley, it was easy to figure out that it was just an insurance situation. Her insurance provider was only willing to pay for the generic version because of the insane price difference between it and the name brand prescription.

While investigating some of these factors that make generic brand Prozac a better option for patients, it was easy to find that a persons’ medical health was of course the first factor, secondly the persons’ type of insurance and their coverage along with that insurance is also a major factor. Although both of these factors are highly influential into why many minorities are not prescribed name brand Prozac, this still does not account for all cases where the minority is physically capable of getting the name brand, and their insurance is able to cover it.

There aren’t too many differences between name brand Prozac and the generic brands, but some of those differences may influence a doctor on prescribing the name brand or generic. To say that the generic brand Prozacs are not as effective as the name brand one is sort of misleading because although name brand Prozac is the most effective overall, the generic brands all are as effective for specific conditions instead of many like the name brand pill is. Being that these generic brand Prozac pills can be just as effective as the name brand pills for specific conditions makes this argument sort of subjective. If a patient (specifically a minority patient) were given a generic Prozac prescription it would go into studies as if it were given to them because of their racial status, rather than under their medical conditions. If this patient were given the generic Prozac brand there is a fairly high chance that they received this specific prescription because of their medical conditions that would refer a physician to the drug, meaning that if the patient had a specific condition that Prozac can treat but they do not have any other symptoms that are needed to treat by Prozac, there are many generic alternatives to turn to because of their more condition specific aid. Along with the fact that a generic brand may treat only the exact medical condition the patient may need, these prescriptions are also cheaper.

Generic brand Prozac prescriptions are easily the cheaper alternative to filling a name brand Prozac prescription. Because of the last point made in the above paragraph, if patients’ medical conditions may benefit from a generic brand pill, there is no reason why the physician should not give them this alternative and save the patient a lot of money. This price factor is probably one of the largest things that influence a physician into prescribing the generic brand. Although not all minority groups or people typically rake in less money than Caucasian persons, it is indeed a trend that occurs quite often. So, being that many minority groups have more money woes than the typical Caucasian person, this should be a very large indicator as to why generic brand Prozac prescriptions are written to minorities more often. It has nothing to do with race in this situation, rather the individuals financial standing. When looking at the price difference between generic brand Prozac and name brand Prozac, it should be obvious as to why generic brands that are basically just as effective is prescribed more often. According to a Fox Business report, “for a month’s supply of Prozac, the brand name costs $136.52, where as the generic is only $3 – more than 95% worth of savings, according to February 2011 rates,” showing that the generic brand prescriptions are much easier to deal with financially (Fox Business Rep, Rogers).

The final factor that counters the argument of racist physicians influencing which type of Prozac they prescribe, whether generic or name brand, is the fact that different types of insurance a person may have does not even cover the name brand pills. Because some different insurance companies may not cover name brand Prozac or the insurance may not be able to cover the high price of it, these cases should technically not be included into research looking for racist physicians causing Prozac to be a “white drug.” For example, cases of minority persons with insurance under Medicaid or Medicare have an extremely lower chance of receiving name brand Prozac compared to people with a different insurance coverage. Although Caucasian people can obviously have these insurance coverage types that typically do not allow the prescribing of high priced name brand Prozac, it is more common for a minority person to have these insurance companies covering their medical expenses. After going through a study done by the University of Michigan’s School of Public Health, a writer for a website called The Vigilant Mom reported that, “researchers also found that patients in receipt of Medicare and Medicaid also had a lower chance of being prescribed the latest in antidepressant medications (specifically Prozac),” (Deborah Pujoue, The Vigilant Mom). With all of these specific factors that counter the argument that it is racist physicians who cause Prozac to be a “white drug,” it is easy to sway someone’s’ feelings on the situation because of all the parameters surrounding the drug like price and medical insurance.

If an individual were to look into this situation of Prozac being a “white drug,” their opinion on the situation would most likely depend on which side they read about first. This seems to be the case because although there are much more unsettling factors into why Prozac is typically prescribed to Caucasians rather than minorities, there are many factors as to why this happens as well. Overall, the situation does not sit well in ones’ stomach at all because just the fact that this is a situation that has to be researched so heavily makes one weary of the medical world in general.

Works Cited

Sources to follow.

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One Response to Research Position—Dan Primavera

  1. davidbdale says:

    Dan, if we had another fifteen weeks, and if I kept hammering on you to reduce the extra language in your sentences, and if you kept working as hard as you have been, you could get to be really good. You have good instincts for research and arguing, but your words, words, words keep getting in the way. Someday when you have an hour, let’s sit down with one of your papers and go through it line by line. With a little practice, you could retrain that voice in your head that tells you to explain, explain, explain when in reality your readers know what you’re going to say long before you get to the point.

    You know, I trust, that I only mean to encourage you. This is a lesson you can learn and I’d be happy to help you.

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