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It's primarily private insurance (at least in the US) that drives that. The doctor can prescribe something and then a "doctor" who works for the insurance company can take a 10 second look at it and deny it outright in favor of a more profitable treatment.
When it comes to costs, yes, but there is also another angle.
Sometimes doctors will prescribe expensive, patented drugs when cheaper, better, out-of-patent alternatives exist.
This is not to the benefit of the insurance companies.
Rather the pharma industry and regulators act in a concentrated rap battle: the regulator covers their ass by only approving in accordance with the latest, most comprehensive studies ("evidence based practice") and the pharma industry only bankrolls new studies on their most profitable medications.