A question about Healthcare in the US, please
#16
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Re: A question about Healthcare in the US, please
I understand your frustration, but when doctors insist on prescribing branded drugs when there are generics available, one of the drivers of medical costs is the huge price differential between the branded and generic drugs, and I for one am glad that someone is keeping an eye on the cost of prescribing branded drugs when there are generics available.
To be totally clear, I have no issue with people in Augigi's situation where there is no generic equivalent and she needs the branded drug, but others shouldn't be allowed to inflate the cost of medical insurance by having insurance pay unnecessarily for branded drugs.
To be totally clear, I have no issue with people in Augigi's situation where there is no generic equivalent and she needs the branded drug, but others shouldn't be allowed to inflate the cost of medical insurance by having insurance pay unnecessarily for branded drugs.
#17
Re: A question about Healthcare in the US, please
I'm not confusing it. Lipitor was on patent until about a year ago and therefore only a brand name drug was available and that is what I am talking about. It is pure stupidity for a doctor to prescribe a brand name drug or a patient to demand a brand name drug when a generic is available such as Zocor which has been off patent for many years instead of the generic Simvastatin. You probably noticed that Lipitor has not been advertised for over a year.
I don't think that a doctor prescribing a brand name drug or a patient demanding a brand name drug when a generic is available is a big problem since an insurance company can say no since a patient or doctor can't prove that the brand name drug is better of different than the generic.
At the VA hospital they always start with generic drugs first and don't carry brand name drugs that have a generic equivalent and only then will they prescribe brand name drugs that don't have a generic equivalent.
I don't think that a doctor prescribing a brand name drug or a patient demanding a brand name drug when a generic is available is a big problem since an insurance company can say no since a patient or doctor can't prove that the brand name drug is better of different than the generic.
At the VA hospital they always start with generic drugs first and don't carry brand name drugs that have a generic equivalent and only then will they prescribe brand name drugs that don't have a generic equivalent.
#18
Re: A question about Healthcare in the US, please
As long as the drug doesn't do more harm than the generic drug of the same type and the drug manufacturer can prove the drug to be somewhat effective, it is usually approved by the FDA. The most common occurrence of this happening is with serotonin antidepressants since none are very effective. Therefore there are at least 30 serotonin antidepressants on the market and new ones introduced each year and none seem to work very well.
Last edited by Michael; Dec 25th 2014 at 4:04 am.
#19
Re: A question about Healthcare in the US, please
I'm talking about the same type of drugs. For instance, a new Beta Blocker could be approved with a 20 year patent that may not be as effective as the generic Beta Blocker Metoprolol Succinate but will still be approved by the FDA. They are both Beta Blockers but with different chemical compounds.
As long as the drug doesn't do more harm than the generic drug of the same type and the drug manufacturer can prove the drug to be somewhat effective, it is usually approved by the FDA. The most common occurrence of this happening is with serotonin antidepressants since non are very effective. Therefore there are at least 30 serotonin antidepressants on the market and new ones introduced each year and none seem to work very well.
As long as the drug doesn't do more harm than the generic drug of the same type and the drug manufacturer can prove the drug to be somewhat effective, it is usually approved by the FDA. The most common occurrence of this happening is with serotonin antidepressants since non are very effective. Therefore there are at least 30 serotonin antidepressants on the market and new ones introduced each year and none seem to work very well.
Similar to what you said about VA hospitals, NHS hospital pharmacies in the UK are able to freely substitute any generic drug if the doctor prescribes a brand name drug. They obviously cannot do the same with "similar" drugs. "High street" (retail) pharmacies in the UK have to dispense the drug exactly as described on the prescription, so not only do they have to stock high(er) cost drugs but they have to stock two or more versions of many drugs.
Last edited by Pulaski; Dec 25th 2014 at 4:17 am.
#20
Re: A question about Healthcare in the US, please
Nothing to do with drugs. In this case it was a local eye doctor they already approved me for, but denied my daughter. Same plan, same doctor. Instead they want to send her to one 60 miles away who is more expensive and has no experience in our relatively rare eye conditions.
#21
Re: A question about Healthcare in the US, please
OK, so as I first said, paraphrasing, you wrote one hybrid post talking in part about "generics" (pharmaceutically-identical drugs), and partly about similar non-identical drugs (I previously said you had "confused" the two). The two are quite separate issues, though both have large cost implications.
#22
Re: A question about Healthcare in the US, please
I agree that maybe I cause some confusion since over the counter drugs are always on the shelves as brand name and generic and some people tend to pay the high price of the brand name drug but in those cases, the cost is still fairly reasonable for a 30 day supply. However for prescription drugs, a person normally isn't going to demand a brand name drug that costs over $100 when they can get the same drug but generic for a few dollars.
#23
Re: A question about Healthcare in the US, please
Many people in both the UK and the US seem to treat their doctors as infallible gods, and won't question their doctor's advice, including the drugs prescribed. Who knows why a doctor might prescribe the brand drug instead of the generic, but I bet some do, and I doubt many people would notice, much less question the decision.
#24
Re: A question about Healthcare in the US, please
I have a friend that started getting severe depressions when he was in his late 50s and was hospitalized when his physician/psychiatrist couldn't figure out how to stabilize him. Eventually he was prescribed a cocktail of 3 serotonin drugs and he was ok. However about every 5 years, he relapses and is back in the hospital and a new cocktail is found. I suspect pharmaceuticals discovered this is a good way to make money by changing the compound slightly instead of spending the money to figure out what will really work.
Personally I think they are on the wrong track with serotonin drugs.
If fact studies have shown that serotonin drugs are no more effective than placebos for most people but researchers don't want to stop prescribing serotonin drugs since if a person feels better, that is the important thing. However if the depressions are severe, the serotonin drugs seem to help.
But a report recently published in The Journal of the American Medical Association showed that the drugs work best for very severe cases of depression and have little or no benefit over placebo (inactive pills) in less serious cases.
Antidepressants: Effectiveness, Trials, Realistic Expectations
Personally I think they are on the wrong track with serotonin drugs.
If fact studies have shown that serotonin drugs are no more effective than placebos for most people but researchers don't want to stop prescribing serotonin drugs since if a person feels better, that is the important thing. However if the depressions are severe, the serotonin drugs seem to help.
But a report recently published in The Journal of the American Medical Association showed that the drugs work best for very severe cases of depression and have little or no benefit over placebo (inactive pills) in less serious cases.
Antidepressants: Effectiveness, Trials, Realistic Expectations
#25
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Re: A question about Healthcare in the US, please
Yeah, well I agree, that's daft. I have no particular concerns about medically valid decisions, but prescribing high cost drugs/ treatments is, IMO quite rightly, being clamped down on, when there are low(er) cost alternatives that are either generics, or similar low-cost drugs that have a similar likelihood of being effective.
I don't get the mentality of buying stuff like Advil when the active ingredient is Ibuprofen which you can buy a hundred of for the same price as a strip of Advil.
Do you mean SSRIs? If so, I would tend to agree from the few that I was experimented on with (erm... didn't quite make sense). The side effects were far worse than the supposed benefits - and missing a dose by just a couple of hours was one of the worst feelings I've ever had.
Changing the subject slightly, with Kaiser the nurse you always saw before the doctor always asked what drugs I was on. She would read a name I'd never heard before, which wasn't on her screen, not on any medicine or eye drop bottles, and would often turn out to be some brand name. Why do that? Why not ask what's on the screen which is also what's on my prescription, and which is also what is dispensed?! Not just one nurse - all of them! Aaargh!
#26
Re: A question about Healthcare in the US, please
Do you mean SSRIs? If so, I would tend to agree from the few that I was experimented on with (erm... didn't quite make sense). The side effects were far worse than the supposed benefits - and missing a dose by just a couple of hours was one of the worst feelings I've ever had.
Personally I think the very old antidepressants work better especially for younger people such as the Tricyclic antidepressants (Amitriptyline or Elival) but doctor seldom prescribe them anymore except for sleep (not addictive like the newer sleep drugs like Ambien, can take them forever, and often works better). In fact there have been studies that Tricyclic antidepressants are better than placebos.
Although as an antidepressant, it is supposed to be taken 3 times per day but it works for some people just before bedtime at a very low dosage (5-10 mg) and it is dirt cheap.
I suspect why Tricyclic antidepressants seem to work for some people is that it can possibly turn off a spinning brain when going to sleep and a person can wake up refreshed. The most common side effect is dry mouth and depending on your metabolism, it can possibly cause tiredness. Some people in the 1970s had good luck with them.
The Comprehensive List of Antidepressants - on RxList
Last edited by Michael; Dec 25th 2014 at 8:28 am.
#27
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Re: A question about Healthcare in the US, please
Not just drugs, it's as if people lose all sense of value for money in the drug store. I buy Pepsodent toothpaste at 99c a tube, the brand name ones are in the $2.50 to $5 range. My acquaintances who buy this expensive brand name stuff are the ones who tell me they will never be able to afford to retire.
#28
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Re: A question about Healthcare in the US, please
This is crazy, it seems incredibly prevalent in the US. I suspect it is to do with TV advertising, an added cost of marketing and product placement which is why the brand name product is so expensive. I don't have TV, so the brand names mean nothing to me. In conversation, I always refer to ibuprofen or acetaminophen (for instance) but many people only seem to know the expensive brand names. Further, the drug store places expensive brand name aspirin beside their own label version which is much cheaper. But the brand name aspirin gets better shelf placement, which they presumably pay for...
Not just drugs, it's as if people lose all sense of value for money in the drug store. I buy Pepsodent toothpaste at 99c a tube, the brand name ones are in the $2.50 to $5 range. My acquaintances who buy this expensive brand name stuff are the ones who tell me they will never be able to afford to retire.
Not just drugs, it's as if people lose all sense of value for money in the drug store. I buy Pepsodent toothpaste at 99c a tube, the brand name ones are in the $2.50 to $5 range. My acquaintances who buy this expensive brand name stuff are the ones who tell me they will never be able to afford to retire.
#29
Re: A question about Healthcare in the US, please
This is crazy, it seems incredibly prevalent in the US. I suspect it is to do with TV advertising, an added cost of marketing and product placement which is why the brand name product is so expensive. I don't have TV, so the brand names mean nothing to me. In conversation, I always refer to ibuprofen or acetaminophen (for instance) but many people only seem to know the expensive brand names. Further, the drug store places expensive brand name aspirin beside their own label version which is much cheaper. But the brand name aspirin gets better shelf placement, which they presumably pay for...
Not just drugs, it's as if people lose all sense of value for money in the drug store. I buy Pepsodent toothpaste at 99c a tube, the brand name ones are in the $2.50 to $5 range. My acquaintances who buy this expensive brand name stuff are the ones who tell me they will never be able to afford to retire.
Not just drugs, it's as if people lose all sense of value for money in the drug store. I buy Pepsodent toothpaste at 99c a tube, the brand name ones are in the $2.50 to $5 range. My acquaintances who buy this expensive brand name stuff are the ones who tell me they will never be able to afford to retire.
#30
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Re: A question about Healthcare in the US, please
I'd never even heard of Motrin until I came here - though I understand you could get it in the UK too.