[The Doctor’s Office is written by Benjamin Brewer, a doctor with a family practice in Ill.]
One of the dangers of Medicare D(isaster) is the heavy reliance on the formularies and insistence on generic rx’s is putting patients at serious risk, as opposed to relying on the medical judgement of the treating physician. A few examples:
- A 95-year-old patient w/stable heart failure visited her doctor recently. Her Medicare D(isaster) plan restricted the rx’s that her doctor was able to prescribe. For the past five years, the patient had been stable on the same rx’s, w/the prescriptions written DAW (Dispense As Written). Generic rx’s were tried earlier, due to restrictions by an insurance carrier. However, the generics that were tried, increased the woman’s pottassium levels. High potassium levels can make a persons’s heart stop.
- Another Medicare D(isaster) patient complained of chest pain and esophagitis after her heartburn drug, Nexium, was changed to a generic (Prilosec) which is approved by her Medicare D(isaster) plan. After experiencing these problems, the patient stopped her osteoporosis medicine and one of her blood-pressure medications.
- Medicare D(isaster) also has an impact on those in nursing homes. The only drug for overactive bladder on one nursing-home patient’s Medicare D(isaster) formulary has the following side effects: dry mouth and blurred vision. This rx needs to be taken three times a day as opposed to taking a newer rx w/less side effects once a day. Due to the blurring of her vision, she will be at risk for falls.
The above-described true situations are just three examples of the harm that some have experienced under Medicare D(isaster). Patients can also incur unnecessary stress, which can also cause/exhacerbate physical symptoms. In addition, changes to less expensive generic rx’s w/increased side effects, more office visits and additional testing are necessary to determine if aditional physical problems are a result.
One of the reasons for this could possibly be the compostition of generic rx’s as the medicine in the generics is the same, but the fillers are not. For this reason, some patients are unable to take generics w/o experiencing severe side effects. And, after conferring w/their doctor, their prescriptions are written DAW (Dispense As Written) out of medical necessity.