The government got between me and my doctor

I got a letter from the government, saying that they contacted my doctor and made him replace a daily prescription of mine with another drug of their choosing.

They were kind enough to allow me to finish my current bottle before experimenting with the cheaper (for them -- same cost to me) product. Wasn't that generous of them?

Oh, wait, that wasn't the government. That was my health insurer. No problem, then!

I sure hope we get a "uniquely American" solution that keeps these swell folks in charge of our nation's health care.

complained that Medicaid made him do that, and Obama told the man that that's what should happen. Why pay more for the name brand if the cheaper stuff works just as well or better.

Now, Medicaid put the man back on the original name brand when two substitutes were tried and didn't work. If the new drug doesn't work for you and the insurance company won't pay for the good stuff, then you have a good anecdote.

... introduce an Orwellian, interfering element into health care. I'd say we've had that element in the system for quite some time.

I'd be more open to being a cost-control guinea pig to help my fellow Americans get access to a universal, single payer plan than to do so for the profits of insurance-industry fat cats.

BTW, the likely "public option" plans won't allow me to choose a different plan than my or my spouse's work-provided plan, so if "ObamaCare" with its not-so-strong, not-so-robust public option passes, so I'll still be in the lovin' hands of my PPO/HMO.

just a different label

Not always. This is a different composition.

I support the right of the insurer (private or government) to require that less expensive formulations be tried, in most cases.

My HMO is paying for Nexium, which isn't cheap, but they required documentation that less expensive drugs had been tried first. I have no problem with that.

...but it's also important to realize that generics are occasionally NOT a viable substitute for certain drugs.

Sometimes the cheaper drug is prescribed for the same condition, but works in a different way or has a slightly different effect. Anti-hypertensives fall into several classes. They have have different side effects. Check out the Mental Health Group for all the stories about how this drug works for one person and does nothing for the next. It's practically standard procedure to try several differ SSRIs to find the one that works.

Sometimes the cheaper drug is different than the name brand because of the so-called inactive ingredients. The name brand may release the dose slowly over 12 hours while the generic dumps the dose in the first hour. It's the difference between a steady blood level and a sudden shock load.

Sometimes the generic just doesn't have the quality control of the name brand. I don't have the actual numbers, but say the requirement for the dose is within plus or minus 1 milligram. That's fine when the normal dose is say 20 milligrams. But when the dose is say 0.1 milligram to 0.3 milligrams, that plus or minus 1 milligram control is meaningless. I've run into that with one of my prescriptions. When I took the generic, I was constantly getting too much or too little, confirmed by blood tests. Now that I'm on the name brand, my dose has been the same fore several years.

That said, most of my prescriptions are filled with generics.

diff. drug co. & change their formulary.

Usually though, if your Dr. tests you after trying the alt. & says it's not working, they'll let yyou change back.

.

I received one of those letter also. It was as generic as the drug they wanted me on. It was unsigned - just "Sincerely" at the close - hence #3.
I fought back and they renewed my original, albeit over-priced, big-name pharma med. I guess that would be #10!
Thought I'd share my own top ten reasons for this. I sent this in and asked them to just circle the best answer and mail it back.
No response, but I suppose the point was made!

As for the doctor, well at my annual 8 minute exam (I timed it), he mentioned the "mountain of paperwork" that the insurance company laid on him for this!


• Reason #1: We are tired of helping to pay for your medication. It’s cutting into our profits. We are committed to lowering the standard of care to as many of our customers as possible, thereby hopefully killing off as many of you as we can. There will be plenty of suckers behind you. Go take your pills. Get well already!
• Reason #2: We in the insurance industry are proud of our role in helping to destroy the financial foundation of the United States of America and much of the world. We are now committed to bringing our expertise into the health care industry. We have the 37th best health care system in the world, but we pay more per capita than anyone else (World Health Organization data). Our mission as insurers is to be 37th in per capita expenditure as well!
• Reason #3: Do you actually think that “Sincerely” is an actual human being? We don’t read this crap! We don’t care a tinker’s cuss about anything but collecting the premiums!
• Reason #4: We don’t like Pfizer. They are even more of a thief than we are! We’ll give you what we feel is appropriate and you will like it. Besides, if you can write this letter, we’re thinking you’re in decent enough health.
• Reason #5: We enjoy mixing meds. It’s a lot of fun in the office to see the various effects that our prescribed medications eventually have on our customers. Don’t you realize how interminably boring the insurance industry can be without a little fun once in awhile? You obviously have a condition that could be life-threatening. We don’t. Let us have our fun!
• Reason #6: Why are you complaining? Don’t you realize how many people we employ to create all of this bureaucracy? In this economy, you are being unpatriotic to complain about our generous services. After all, you should be grateful that we continue to cover you.
• Reason # 7: All we’re saying is “try it”. What’s the risk? So what, you get a little pain – or your cholesterol goes back up – that’s a small price to pay for the contributions that you are making to our bottom line. We appreciate it!
• Reason # 8: As we said in the denial letter: “this determination does mean that you should not obtain the prescribed medication…(nor) that you do not require the medication”. It just means that we’re not interested in continuing our coverage for it – see reasons 1, 4, and 5.
• Reason # 9: OK, we admit it. “Sincerely” really isn’t an actual person. This letter was created by our awesome computer, which automatically sends this out to people after a pre-programmed prescription limit has been reached. That same computer has read your letter and sent you this reply. Welcome to the most technologically advanced rejection system in the world!
• Reason #10: On behalf of the thousands of our employees, Sincerely, and the most advanced automatic rejection system in the world, we offer our apology. You never should have been rejected for this medication. We are very happy that you are benefiting from Lipitor and we wish you much continued good health. Your prescription has been re-approved!

they are the same with their drug brands too. Generic is just as good.

I take what my doctor prescribed and what works.

Now to pad insurance co. profits, I have to hope another product -- not an identical generic -- does the job w/o side effects.

same drug. The OP said a different drug, and probably meant that. They do that as well. All the time. Such an odd tactic, equating medications to high end fashion brands. Wanting the correct medication is not the same as demanding Prada.

I was taling about brands. A different drug - no.