Trailing Thoughts

I have Tarascon PDA software on my PDA and I must say this is a cool edition. They have added where people can get assistance for drugs they cannot afford. Or you can check out the website:

http://needymeds.com/

It presents an easy format for people to find ways of getting assistance!! Medications are not cheap and if you meet different criteria, there is possible help for you!

I try to read the peach section of the blade ( the Toledo newspaper) every day– I just glance at the other pages headlines – most of the time the stuff is too depressing to read about, and I know I live a sheltered life and for now, I would like to keep it that way. But I have come off the point of this post. Mr. Woods state that Americans are too quick to adapt new drugs that come out, though extensive studies have been done, there are rare side effects that do not occur until millions of people are taking a drug and that they are costly. Here is my response:
When I say that everyone is unique and that people have different personalities even raised in the same environment, it does not suprise anyone. Drug metabolism is just the same — in general, it acts similar, but some people have different responses to medications because something makes the reaction unique. Sometimes that is not the case, like in the case of the drug Thalomid– a drug that was used in the 50s and 60s as a sedative. It was thought to be so safe that even pregnant women were given this drug. As it turns out, many babies were deformed– ok– so we have a side effect that has affected a lot of babies, thus this resulted in the drug being withdrawn from the market. But it turns out, it does have its niche and has been reintroduced into the US drug market with safety precautions– and if used safely– with a complete risk versus benefit analysis — it can be used to treat a symptom associated with leprosy. Now lets compare this with the new drug Crestor ( a “super statin”). There have been reports that Crestor does induce liver failure and has a higher risk associated with this then the other statins. Okay, knowing this why would people need to use this drug? Well, in some cases, cholesterol control does not exist, even maximizing the cholesterol lowering diet and drugs available, so people do a risk analysis and determine if Crestor would help. When people make these decisions that should realize that the monitoring tests associated with these drugs are for a reason and not put them off. They should have have Liver Function Tests done on a regular basis and other parameters.
With so many people on any of the “statins”, risk of liver failure exists, but it is a rare side effect– does this mean that everyone should stop taking statins? No, but they would be stupid not to realize they have parameters that might require testing and that they should follow through with these parameters. The whole point of this was to say that drugs affect people differently and we need to approach this with every medication we take ( even aspirin, which has been around for over 100 years, can affect people differently).
Now lets address the cost issue: Ok, I will admit, the newer treatments will cost more, but sometimes the treatment outcome will outweigh the cost. I know people that suffer from migraines and none of the older treatments work, but the drug Axert works for them. Axert is not cheap, but offers the relief that the older drugs could not. But this is not always the case. When I have someone that cannot afford the newer medication, but did not tell their doctor this, I offer to call their doctor and recommend a therapy change to something that I have available in a generic drug. But sometimes when this is not the case, and the person needs the expensive medication, I try to come up with something that will work for the patient, like maybe a manufacturer discount card. Many pharmacists will do this for their patients, so don’t be afraid to talk to your pharmacist.

I am not discrediting anything that Mr. Woods stated in his article, but I am trying to point out there is more to the picture then he introduced.

My grandmother recieved information for medicare approved discount cards… and asked should she get one? First what is a medicare approved discount card? It is a voluntary card that can give a discount on certain drugs ( usually 10 to 25%) for a small enrollment fee of $30 or less. A person must be eligible for medicare to enroll for a card. A person can only sign up for 1 card per year, so it is best to do some research before you choose a card. Keep in mind, if you are a senior citizen, most pharmacies already offer an automatic discount. Rite Aid is 10%. Another thing to keep in mind that you can only use 1 type of discount for a prescription.
What is the best way to choose a card? Well first you start with a list of the current medications that you are taking. By visiting www.medicare.gov or calling them, 1-800-MEDICARE, to get a comparison list of the cost to you. From there, you can choose your best option.
I will briefly cover 3 of the discount cards offered.
Pharmacy Care Alliance Discount Card:
Will give you up to 20% off some brand name prescriptions and up to 40% off
Many chain pharmacies, including Rite Aid, accepts the card.
Enrollment is $19 or $30 depending on options chosen.
It does not offer discounts in the following categories: weight-related, fertility, cosmetic, cough & cold prescriptions, vitamins, barbiturates, benzodiazepines, OTC drugs, and drugs covered under medicare part B.
They offer some services along with the card including a mail option.
They also maintain a decent website for drug information and interactions: www.drugdigest.org
FOR MORE INFORMATION: www.PCAcard.com

Rx Savings Access Card:
On covered drugs it offers a 15% minimum discount (it can be more) on brand and generic drugs.
Associated with McKesson, a well known name in the drug industry ( they also have the Together Rx discount program)
Accepted at many pharmacies, including Rite Aid
FOR MORE INFORMATION: www.RxSavingsAccess.com

Medco Preferred Prescriptiong Discount Card:
Save on selected drugs up to 30%
Accepted at many pharmacies, including Rite Aid
FOR MORE INFORMATION: www.medco.com/medicare/

I do not know what other pharmacies accept these discount cards. I can only speak for Rite Aid because that is the environment that I am familar with. These discount cards are only going to be good for 1 year at a time and will end in 2006 (when, as the government claims there will be prescription benefits to medicare recipients- this is just to cover the time period before it starts) Also there is a 600 dollar credit that some people might benefit from, but it is complicated to explain exactly who benefits, so it is best to contact medicare.

Some pharmacies will have information packages available to their patients, just ask your pharmacist.
We personally decided to not look into a card for my grandmother ( she does have insurance, and we feel this would not be an added benefit) but for the people that do not have money to pay for insurance or cannot get coverage and are covered by medicare, these are an option to save some money.
Remember there are other options for discount cards — if you need assistance, start looking – for instance AAA Travel offers a discount program to their members or most drug companies (Eli Lilly , etc. ) offers specific drug discounts. For instance, if you qualify and fill out the forms, it is possible to get a discount on a drug that the company makes. I knew a lady that qualified for prozac and reduced her amount from paying full price to a 5 dollar co-pay.
Also if you don’t qualify for any of these discount programs and do not have insurance, make sure when you get prescriptions, that you request a drug available in generic. You would not believe the amount of people that go to the emergency room with out insurance and come out with a prescription for an expensive antibiotic when they could have gotten something similar for a lesser amount if they just mentioned it to the doctors.

Another thing for people that do have prescription coverage through their insurance. Be familar with your insurance company’s formulary– you can save a lot of money and time if you bring it with you each time you visit the doctor office and get something that is a preferred item than something that is not preferred. With one patient I encountered, they did not do this and came up with a $50 dollar co-pay because the doctor chose the drug that is not on the formulary, and when it was switched to the preferred it was only $5 dollars. ( How to get a formulary – contact the insurance company- there is a number usually on the back of the card, contact your benefits office or visit the insurance company’s website) .

I don’t know about other pharmacists, but I am always confused on what drug works on which enzyme or vice versa and can never remember the effect. From studying for the boards, I found this great link that has a pretty comprehensive table. I was very impressed and cannot wait for them to come out with the PDA version.