Drug Costs

[Feralpeg]

I took DD to the dermatologist today. She's been having some problems lately. The doctor decided to give her an antibiotic. I dropped it off at the pharmacy and went to dinner. When I came back to pick it up, the pharmacist told me that she hadn't filled the perscription because she thought I might not want it. The doctor had put on the perscription that it had to be the name brand version of the drug. The cost for one month's worth of the antibiotic after my insurance would be $400.00. I couldn't believe it. I asked if there was a generic version and she said there was, but she could not fill it that way due to the way the perscription was written. She told me that this particular doctor always writes the perscriptions that way. I am going to call the doctor tomorrow and tell her that the only way DD is going to take the drug is if we can have the generic version. I can't believe anyone would be willing to pay that amount!

 

[chell]

Sometimes you have to think that they don't want people to take the meds.

 

[Kermit]

That is rediculous. Even if the doctor thinks there is some valid reason for not dispensing the generic, he should share that reason with you. I know that doctors need to feel free to prescribe the most effective medication they know of, but they also need to be aware that when they choose the most expensive ones that their patients may not take the medicine at all.

 

[clh2]

Unfortunately, there are many Drug Sales Reps that are pressuring the Docs to write drugs for the brand name only. And while it may have been toned down a little, drug reps/companies have sponsored many lunches, trips, "educational" conferences etc.

I truly think the Doc's have absolutely no idea how much they cost. Once you have the doc on the phone - ask him if he has any samples of that particular drug

 

[minniecarousel]

I think some doctors are just plain oblivious to the cost of some prescriptions! After all, they get theirs for free!!

 

[Towncrier]

Sometimes the generic does not work as well as the brand name, but that is not often the case. Our doctor knows that we have prescription insurance, but I had to explain to him that it was for formulary drugs and generics. Anything else (Z-pack for instance) costs us the proverbial arm-and-leg. Since explaining that to him, he has prescribed lower cost antibiotics that have similar pharmacology and do just as good a job.

We had the opposite problem the last time the doctor wrote Sue a prescription for Dilantin. He neglected to put "DAW" (dispense as written) on the script. Or at least Caremark claimed that he forgot. So they sent Sue the generic. This is one case where the generic is not equivalent and we ended up stuck with a 3 month supply of pills that Sue could not use and that we could not return. Oops.

Good luck finding a less expensive alternative treatment for your DD.

 

[CDoobee]

I work at a doctor's office, and in the case of my doc, it's just a "slip of the pen". He also has an office across the river in another state. In that state the "dispense as written" line and the "may substitute" line are on the opposite sides of the script. He gets so used to doing it that way in the other state (he's worked a lot longer in that state, also), that he just automatically signs on that side on our scripts. If I can catch him in time, I have him sign on the "may substitute" line. If not, I am always able to tell the pharmacies that generics are okay when they call.

 

[Geoff_M]

And while it may have been toned down a little, drug reps/companies have sponsored many lunches, trips, "educational" conferences etc.

"Toned down" is bit of an understatement... it's illegal. The US Government just "dinged" Swiss drug maker Serono SA to the tune of $704M for doing that: http://www.boston.com/business/globe/articles/2005/10/18/704m_penalty_for_drug_maker/

 

[tiggersmom2]

I work at a doctor's office, and in the case of my doc, it's just a "slip of the pen". He also has an office across the river in another state. In that state the "dispense as written" line and the "may substitute" line are on the opposite sides of the script. He gets so used to doing it that way in the other state (he's worked a lot longer in that state, also), that he just automatically signs on that side on our scripts. If I can catch him in time, I have him sign on the "may substitute" line. If not, I am always able to tell the pharmacies that generics are okay when they call.

Yep, this is the same way it is where I work. We have different prescription pads and the Doc may forget. I do not know of a Doc that will not allow a generic drug if the patient needs it.

 

[Feralpeg]

I work at a doctor's office, and in the case of my doc, it's just a "slip of the pen". He also has an office across the river in another state. In that state the "dispense as written" line and the "may substitute" line are on the opposite sides of the script. He gets so used to doing it that way in the other state (he's worked a lot longer in that state, also), that he just automatically signs on that side on our scripts. If I can catch him in time, I have him sign on the "may substitute" line. If not, I am always able to tell the pharmacies that generics are okay when they call.

No, the doctor wrote "Medically Necessary" on the perscription. The pharmacist said that means they can only fill it with the name brand drug.

 

[Pop Daddy]

this is why i quit doing drugs

 

[mudnuri]

Okay I have to jump in here.

There is a reason some drugs have a generic and some don't- its all about the patent for the drug....When say- Merck developed Singulair, the FDA, gives them X years (I believe its 5) when no other company can manufacture singulair- or the generic (which i dont believe there is yet)..

I attended a wellness conference, and a leading pharmacutical (sorry cant spell tonight) company sent reps. What they didnt realize is their was also specialists in drugs their...

Basically- the majority of the time, the same company that makes the name brand drug- will produce the generic...

There is no difference in generic drugs, I'm not sure why some people think their is...their just isnt- the color might be different or the shape, but the chemical composition of them is the same

Brandy

 

[Pooh Girl 71]

Actually the patent for the brand name drug is 19 years (or at least it was in the late 90's when I worked in insurance).

 

[Feralpeg]

The point is, there is a generic version of this drug. The pharmacist told me there was. She just couldn't fill the perscription that way because of the way the doctor wrote it. If the doctor won't change it, we will be seeing a different doctor. As much as I want my DD's complexion to be beautiful, I'm not paying $400 a month for it.

 

[Kimberly]

The generic brand might not be that cheap. Often "cosmetic" drugs are not entirely covered by insurance and/or very expensive to begin with. The generic might cost half as much, but that's still 200 dollars per month (and it's probably slightly more or less than that).

Some people would argue that brand name drugs are so expensive because of generics. Brand names only have so long to make up for research and development before generics are allowed on the market and cut out of their profits.

 

[Geoff_M]

Actually the patent for the brand name drug is 19 years (or at least it was in the late 90's when I worked in insurance).

It's 17 years... from date of discovery, not from date of FDA approval. IF a drug is approved, it can often take more than 10 years to accomplish. A small Waxman-Hatch extension of 2 years can be applied for under certain circumstances (such as a novel use requiring additional research and regulatory approval).

 

[golfgal]

I would check with your insurance company and see if they cover "medically necessary" name brands like they would for generics. I know we have that clause in our insurance information.

 

[Christine]

Okay I have to jump in here.

There is a reason some drugs have a generic and some don't- its all about the patent for the drug....When say- Merck developed Singulair, the FDA, gives them X years (I believe its 5) when no other company can manufacture singulair- or the generic (which i dont believe there is yet)..

I attended a wellness conference, and a leading pharmacutical (sorry cant spell tonight) company sent reps. What they didnt realize is their was also specialists in drugs their...

Basically- the majority of the time, the same company that makes the name brand drug- will produce the generic...

There is no difference in generic drugs, I'm not sure why some people think their is...their just isnt- the color might be different or the shape, but the chemical composition of them is the same

Brandy

This is not always the case.

Take Prilosec for instance. From what I heard, the manufacturing process of Prilosec had seven patents on it. When the drug was released for generic manufacturing, not all 7 patents were released and only 4-5 patents were released. This allowed the "active" version of Prilosec (omeperazole) to be manufactured by anyone, but the exact formula of the entire pill (capsule, binders, etc) were not released. The generic Prilosec has a very different response rate than the old Prilosec. I know that Prilosec OTC does not work for me, and the generic prescription Prilosec gives me dry mouth very badly. So, while the active ingredient is the same, the binders can make a huge difference.

I also take Synthroid. My doctors insists that I take the brand name because if I get generics than I will get a different "generic brand" on any given month that I do to the pharmacy. Each generic has a different "recipe" and changes my TSH quite a bit. So, it is important that I stay with the same brand every month. There is nothing wrong with the generic Synthroid but they cannot guarantee me the same one every month and thyroid patients cannot tolerate the flucuations.

 

[DawnCt1]

Unfortunately, there are many Drug Sales Reps that are pressuring the Docs to write drugs for the brand name only. And while it may have been toned down a little, drug reps/companies have sponsored many lunches, trips, "educational" conferences etc.

I truly think the Doc's have absolutely no idea how much they cost. Once you have the doc on the phone - ask him if he has any samples of that particular drug

Those little trips, lunches, etc are completely off the table and have been for years. I cannot even attend an evening meeting where DH is a guest speaker. Years ago, and I am thinking it was close to 25 years ago, DH did a study on antibiotic streamlining, which was a major issue in most hospitals at that time. There was little regulation with each hospital and formularies were fairly broad, and often, surgeons, worried about post op infections would infuse multiple antibiotics that covered the same range of possibilities. When Infectious Disease oversight, hospitals could cut their costs tremendously. DH's first job out of his fellowship was to implement the cost savings with the results of his study. The first year, he saved the hospital double his salary. It was "new ground" then. Surgeons in particular were very skeptical and initially unwilling to give up name brands that they were familiar with and a protocol that worked anyway. I would guess that habitual writing is the reason for brand names vs. generic and also with some drugs, bioavailability and efficacy are sometimes better. In this new age of super antibiotics, some have not made their way into the world of generics. In the past, Tetracycline was useful for acne, in some case Diclox. Tetracycline is relatively cheap. I also think that many forget that Pennicillin still works for strep throat.

 

[chrissyk]

Aside from the drug costs, I wanted to mention something here. Antibiotics for acne are not always effective, and they can have side effects like antibiotic resistance, regular antibiotic side effects (yeast infections, diarrhea), and even turning teeth brown (this happened to my friend who was on Tetracycline). I was put on Tetracycline for acne as a teen. Luckily, my mother made me stop taking it quickly. It wasn't working, and it could have had some nasty side-effects down the road.

After trying what seemed like everything to get my teenaged acne under control, I was put on the birth-control pill. That cleared my skin right up in like one cycle. Same thing for my sister, and she got adult acne so bad that she was even breaking out on her back! Anytime I've stopped taking the pill, the acne comes right back. For a lot of teens, acne is the result of hormones. I thought that perscribing antibiotics for acne had gone by the wayside...you might want to do some research on the practice even if your insurance company does agree to cover the drug. Antibiotics for acne are something that I'd only consider as a last resort before Accutane...too many possible side effects/resistances.