The patient rarely draws the line if they aren't footing the bill IMO.
And a lot of doctors don't realize how expensive most drugs are because they don't buy them and the pharmaceutical reps don't ever seem to mention it.
And that is the problem with "free" anything. If I am responsible for the bill I look at the options much closer. And I have found that a couple of questions to the doctor will usually lead to them prescribing a lower cost alternative.