Friday, May 20, 2005

Healthcare and Big Pharma Make Me Sick...

The United States healthcare system and "Big Pharma" are beginning to drive me nuts. The quality of healthcare is in an inverse relationship to it's cost for each year as premiums increase, the level and quality of service remain on a steady decline.

I recently made an attempt to get an appointment with my primary care physician because of respiratory symptoms that I have been recently battling. These symptoms are usually caused by the increase of environmental allergens that plauge me and my entire family in springtime. When I placed my call, the first thing to notice is that I get an automated system in which I must go through at least three menus; just to then get a message that states to "remain on hold and your call will be answered in the order it was received." When my call is finally taken, it's the answering service that answers in almost a robotic tone and explains that the doctors are in a meeting, and won't be available until 4:30 PM. This was at 12:45 PM. She then takes all of my information, and tells me that someone will contact me.

I go about business as usual, and finally I receive a call from a doctor -- about 4:10 PM-- who asks me how he can help me. During our conversation, it becomes clear that the doctor has determined that I am not sick enough to get an appointment, and he will call in a prescription to my pharmacy. I am to begin taking the meds immediately and they should "clear me up in no time." So, I follow the doctor's advice, and I take the medication as prescribed for two weeks. What do you know... I feel worse.

I then go through the procedure of calling the office, go through the menus, get another robot who then takes my information so that I can get another return call. However, this time I change my strategy. I go to the office, sit in the lobby, and wait for the doctor's call. When I receive the doctor's call, I explain that I am in the lobby, at which time she tells me that she will see me since I am in the lobby (notice now it is she instead of he). I then fork up my $20 co-pay, and await the calling of my name. After approximately 20 minutes, a nurse calls my name and seats me in a room, takes my temp and blood pressure, and tells me the doctor will be in shortly. After another 20-minute wait, the doctor comes in, looks at my chart, listens to my lungs and writes more prescriptions for different meds that will "clear me up in no time". The visit with the doctor took all of 8.5 minutes. No time for questions, got patients to see.

So for my 20 bucks, I get to waste 40 minutes, plus gas and transportation time for the opportunity to spend more money on more prescriptions.

So I then head to the pharmacy to get the medications, which; of course, are outside of the HMO's formulary, which means they will need prior authorization from the physician. What the heck does that mean to me. I spend over $200 a month for coverage, and the HMO can't spend $85 so that I can feel better. Word has it that there is a over the counter that may offer similar results, but may not be nearly as effective as the prescription strength medication. However, even that will cost close to the same amount if you were to average the over an entire month.

Part of the blame for my anguish should be place on "Big Pharma". These guys spend billions of dollars a year advertising medications to consumers who hardly understand exactly what the medication is designed to treat. You know the adverts that usually end with "ask your doctor if ------- is right for you." Did you know that these companies are also in the practice of wooing family practitioners with lavish gifts, golf outings, dinner and Caribbean trips just to ensure that they will continue to write prescriptions for their drugs. Guess who foots the bill.... the consumer. What's also quite disturbing ia that they will typically bundle their marketing budgets in with the "Research and Development" budgets.

Research and development??? Isn't that a trip?

Most of these companies are only researching how to copycat drugs with high profit margins whose patents have expired. This in turn does what??? You've guessed it... drive up the cost of all the medications in the same class (see prilosec, nexium, claritin for examples). It's idiotic. For example, to control my asthma, I have to take five separate medications that cost over $110 total per month. Two of these are not included in the HMO's formulary. If I weren't financially able, I wouldn't get them (which is why I ended up in this predicament in the first place). This in turn would mean more trips to the doctor, to spend more money. More trips to the ER, to spend more money.

Who does this help??? "Big Pharma" and they are making me sick... Literally...

1 comment:

Anonymous said...

My name is Jon Star and i would like to show you my personal experience with Nexium.

I am 34 years old. Great medicine. I only hope that I don't become dependant on it. But as my esphogus heals then maybe I'll be able to take an OTC PPI if my symtoms re-occur and I catch them ASAP! Can't wait for a generic. BLUE CROSS of MA won't pay for Nexium unless I start on generic Prilosec, then Protonix, then if both of those failed, they would pay for Nexium. I hate BLUE CROSS! My Dr. was great in giving me 7 weeks of samples when he heard this and Aztra-Zeneca gave me a 7-day coupon I re-deemed at my local pharmacy(with a written 7-day script from my Dr.)

No major side effect. Sometimes a feeling of indigestion/bloated, possibly due to low or no stomach acid as a result of a PPI. So, I am sure to chew my food well and not to eat large portions. I have introduced foods/drinks back into my diet, that before taking Nexium would otherwise bring-on reflux symtoms. Fruit juices and citric acid containing drinks still are bothersome. But, I've eaten Pizza, and am able to drink coffee/tea, both decaf(not to excess though.) A little at a time. I do not drink any alcohol! I still limit any food intake 3 hours before bedtime and try to sleep on my left side. Nexium has given me the greatest relief as compared to all OTC H2 and OTC PPI's. I'm on week 5 of an 8 week treatment.

I hope this information will be useful to others,
Jon Star

Nexium Prescription Information