If you were or are a doctor what's the right thing to do

If a patient is on Medicaid and is severely allergic to a generic drug (and needs an expensive brand name drug instead), what would you do?

Medicaid will pay for the expensive one if the doctor writes that it is medically necessary. No conflict or problem there.

Also, you seem to be confused about generic vs. brand names. If someone is allergic to the active ingredient in a generic drug preparation, he/she will be just as allergic to that ingredient in the expensive version. It's the same thing, just without all the marketing hype and inflated price.

That actually happens all the time - insurance companies dictating drug choices, even if it means prescribing what is NOT best for the patient. Personally, I prefer my doctor to make those decisions, not some insurance company beancounter.

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The chemical in the generic is identical to the brand product. Indeed often the generic is made by the same company making the original. The Brand gets a 17 year patent on the chemical. After that, any licensed pharmaceutical laboratory/manufacturing plant can make it if they so choose.

Standards are set for the manufacturing of any drug.

So, your problem doesn't exist.

Ask any pharmacists.

Aspirin is aspirin. Neuronton in Neuronton. Estrogen is estrogen..... it's the same dog, different collar.

Adhere to the Hippocratic Corpus, often stated in short form as "first, do no harm." Mis-prescribing medication, as you are suggesting, is irresponsible and is likely to precipitate into a medical emergency that will be much more expensive to the insurer than prescribing the indicated medication.

Prescribe them the medicine that I know would help the patient and if it is an expensive brand, then so be it.