18 October 2009

Healthcare fail

Eric went to the doctor a couple of months ago, and I have been stewing ever since. I do not make much of a secret of my left-leaning politics and my pro-nationalized-healthcare sentiments. But this whole episode doesn't have a lot to do with that. So you can breathe a sigh of relief knowing that I am not about to bombard you with my political opinions. I am, however, blogging about just one problem with America's healthcare industry.

Eric had been having problems all summer with his allergies. After using practically every over-the-counter medication and not having much luck, he finally buckled down and went to a doctor. He took with him a list of the medicines he had been taking, which included a nose-spray and the generic version of Claritin, called Loratadine. The doctor listened to Eric and then prescribed Claritin-A (or something like that). The doctor warned Eric that it would be a rather expensive drug, but Eric felt like he didn't have much of a choice because he was feeling so miserable so much of the time.

Off Eric went to the pharmacy where he learned that his medicine would cost him roughly $120. He did not expect it to be that expensive. When he told the pharmacist that his allergies weren't $120-per-month bad, the pharmacist said, "Well, Claritin-A is really just regular Claritin mixed with Sudafed." Both of those drugs are over-the-counter medications. The pharmacist called the doctor, had the prescription changed, and Eric went home having spent about $30.

Here are my problems:
  1. Eric was already on Claritin. Why would the doctor prescribe the same drug that was already not working well for him? Aren't there other drugs that are possibilities?
  2. What interest did the doctor have in prescribing Claritin-A? If he knew that it was rather expensive and could be replaced rather cheaply, why would he ever prescribe Claritin-A to anyone? Shouldn't his number one concern be his patients?
  3. Why are drug companies making drugs that already exist? Obviously, the answer behind this is money. It's clear that the drug companies wouldn't research, manufacture and market drugs unless they saw profit behind each drug. They wouldn't see profit behind such a useless drug if the doctors weren't prescribing it.
Am I the only one who thinks this is absurd? Are there any medical personel out there who can shed some light on why this doctor would prescribe something that costs four times the amount of the cheaper alternative?


Fionna said...

Don't even get me started on drug companies and their ties with doctors. I worked at a pharmacy on occasion and the stories I could tell. I have my own personal story as well with an ob-gyn that kept pushing for a procedure to a problem I was having. To make a long story short, he got mad at me because I refused the drug treatment telling him that I would prefer to live with the symptoms. At a subsequent examination he discussed with me solutions to my problem and told me (without looking at my file) that the drugs weren't an option,they wouldn't diminish the symptoms I was experiencing.
Thank goodness pharmacists are usually good to help with isuggestions for cheaper generic drugs.

Jim said...

Hi, I just came across your blog by accident, but this post got me interested!

I should disclose that I'm a doctor in the UK, and there are few things I want more at the moment than for the US to get nationalised healthcare (though I don't get much of a say).

There are a few reasons why doctors prescribe drugs that are too expensive, or have already not worked, in the UK at least.

The first answer is that they are on autopilot: if someone comes to them with an allergy problem, they don't listen fully because they've solved the problem, then they prescribe what has worked most of the time. I'm sure your doctor would have known that his prescription contained loratidine if you'd asked him, but he probably just didn't have it at the forefront of his mind at that time.

The other, more insidious answer, which I imagine is even more prevalent in the US, is that drug companies spend a lot of time schmoozing up to doctors. They buy them lunches, they give them pens, they certainly used to take them on rounds of golf (I think that's been tightened up here over the last couple of years).

This constant exposure works just like any other advertising - we soon forget that the generic versions exist, even though the brand versions are identical and no more effective.

I'll leave it there in the interest of brevity, but if this is a question that interests you further, there's a great science writer here who covers similar issues: check him out at http://www.badscience.net/

Thanks for the great post,


Packrat said...

First, Eric needs to change doctors. Second, has Eric ever had allergy tests done? If not, that is probably something he should do. It is expensive, but if he is miserable...

Christine Brickenstein said...

hey sherry,
that's really interesting to read. We have just watched Sicko from michael Moore and were really shocked :-(
Hope you and eric are doing fine!!
I miss NZ soo much...

Cindy said...

Why doesn't Eric go to an allergy/immunology doctor? I've already been there and done this and the specialist really heard me out and listened to all of my meds and prescribed accordingly.

Carrie said...

Do you think that if more people were told it will be X amount of exorbitant dollars for Y treatment (drugs, specific dr. visit, etc.) that people would "spend" more wisely? Try to find something that costs less or try other things that cost less first?

I think the whole cost factor applies to this post and is something I'm dealing with as I am trying to get my birthing center birth covered at an in network rate. They only cover hospitals in my network. It costs the insurance company MUCH less than a hospital birth, but they don't want to give me an in network exception.

Jon's mom has also mentioned that if given the option to control something with diet or medication, take the diet route and leave the medication as a last resort.
I think society has become to reliant on the fast/easy fix as opposed to taking charge of improving their health and trying to avoid medication. (yes, I recognize that many times medication IS the answer and there is not an alternative).

Shalissa said...

Perfectly described. Couldn't agree more!! so glad Eric found a pharmacist he could talk to, and dared to voice his objection.