Zip. Insurers already require prescribers to try lower costing drugs first before covering higher cost ( and more effective ) drugs . Its not something they will move towards . Its what they already do . My wife prescribes for CKD ( kidney ) patients and usually spends an hour a day arguing with insurers who want her patients to fail on cheaper ( but less effective ) alternatives first .
This difficult economic environment ? Unemployment is very low. Almost 2 job openings for every job seeker. Most / many that could ...refi'd their mortgages when interest rates were very low 2 yrs ago . There's difficulty in certain sectors ...commercial real estate etc , but this is not a difficult economic environment ala 2007 / 2008