Boost your budget from $10 to $1500 for this. . .

[Scanner]

Preemie birth preventive spikes from $10 to $1,500 | AP Health Science - The News Tribune

But Obama and the Democrats were the villians in healthcare reform, right?

[disneysteve]

This is a trend in medicine that has been happening for a while, though this is certainly a very dramatic example. Other examples - I'm sure you've all seen commercials for Mucinex. Did you know that prior to the launch of Mucinex, there were multiple brand name and generic products of the market, both over-the-counter and prescription, that had the same active ingredients. Somehow, Mucinex was granted exclusive rights to sell the compound. Of course, the price shot up. No longer were cheap generic versions available. No longer was there a prescription version that would be covered by your health insurance plan. Nope. All that is left is the brand name OTC version that you have to pay full price for out of pocket. Another example is colchicine, a medication used to treat gout for decades. It was generic and dirt cheap. No longer. There is now a new brand of colchicine called Colcrys that is now the only version of colchicine on the market. The other manufacturers were all forced to stop selling the drug. Of course, this new product is much more costly than the previous generics. I've already had a couple of patients who I had to take off colchicine because they could no longer afford it, after having been on it for many years with good results.

I have no clue what the FDA is thinking but they sure aren't thinking about the impact this has on patients or on doctors' ability to provide appropriate and cost-effective care.

[Scanner]

Lassiez-faire capitalism at it's best and finest.

Yeah, I just took Mucinex. . .that **** is expensive - about $1.00/pill.

The problem is now no one has a right to cry about it IMO. The country sent Obama there to do a job just like they sent Walker to Wisconsin and do a job. When he tried to do it, the Country pitched a fit. I think we've essentially become so dysfunctional, we've lost the right to cry about it.

Well, the people working at the co.'s that make this **** probalby have good jobs and shareholders are paid well - that's all that matters, right?

So, scrimp and save and get an EF. .. in the end, it can be wiped out by unforeseen expenses.

Another thing that chaps my behind is the dual system fee structure. I have to charge an ins. patient and a cash patient the same. . .I can charge perhaps a small "administrative premium" for billing health insurance (maybe 30% at the most over my fee). . .the drug companies can just mark things up 10000% in the name of capitalism and ins. has to pay.

For Aetna the fee is $1500. For someone making $100,000 or less. . .it's $20.00.

Just so wrong on so many levels.

[Joan.of.the.Arch]

KV Pharmaceutical? You mean the KV Pharmaceutical whose CEO is headed to jail with a local judge calling what he did "greed[y], [an] abuse of power and reckless....” ????

Ex-KV CEO Hermelin to serve 30 days, pay $1.9M | St. Louis Business Journal

I've seen all those Mucinex commercials. Had no idea it was just guaifenisin. That stuff has been around my entire life and was in so many cough and cold medicines, or you could buy it separately. Yeah, it was in hundreds of products. I never thought it did squat, but if it helps someone it does make me angry to have it snatched from cheap common production and set aside for a single company only to market. I was thinking that the FDA said about three years ago that its use actually should be limited. If that is the case, why is it being marketed like crazy with prime time TV commercials?

And colchicine, too, you say! Hasn't that been in use for about 160 years, for heaven's sake? Unbelievable.

[Joan.of.the.Arch]

Hmm, must also be this KV Pharmaceutical that has a $27+ million judgement against it as well.

KV Pharmaceutical given more time to pay fine | St. Louis Business Journal

I think I'll go check my medicine cabinet to see if I have anything they've sold.

[asmom]

This is a trend in medicine that has been happening for a while, though this is certainly a very dramatic example. Other examples - I'm sure you've all seen commercials for Mucinex. Did you know that prior to the launch of Mucinex, there were multiple brand name and generic products of the market, both over-the-counter and prescription, that had the same active ingredients. Somehow, Mucinex was granted exclusive rights to sell the compound. Of course, the price shot up. No longer were cheap generic versions available. No longer was there a prescription version that would be covered by your health insurance plan. Nope. All that is left is the brand name OTC version that you have to pay full price for out of pocket. Another example is colchicine, a medication used to treat gout for decades. It was generic and dirt cheap. No longer. There is now a new brand of colchicine called Colcrys that is now the only version of colchicine on the market. The other manufacturers were all forced to stop selling the drug. Of course, this new product is much more costly than the previous generics. I've already had a couple of patients who I had to take off colchicine because they could no longer afford it, after having been on it for many years with good results.

I have no clue what the FDA is thinking but they sure aren't thinking about the impact this has on patients or on doctors' ability to provide appropriate and cost-effective care.

Really? I work for an integrated health plan and we are still using colcichine.....I wonder how that works. And how can they give ONE company the exclusive rights to market a drug so long after patent protection expires?

[Joan.of.the.Arch]

Arrgh. Trying to counteract the head explosion I feel coming on, I've poked around a bit and found that the generic of Makena, the premature birth preventative medicine, has been in use since 1956. 17-Hydroxyprogesterone - Wikipedia, the free encyclopedia

And as I think Scanner's linked article points out, it can already be obtained from a compounding pharmacist. Problem is: not buying it now from the off-the-rack maker may make the prescribing doctor and the compounding pharmacist open to lawsuits. And we already know that people are rather sensitive about the outcome of their pregnancies and health of their babies. Yes, there might indeed be lawsuits if premature birth was not prevented when the pregnant woman took the pharmacist compounded $10 vial of the same medicine that now will cost $1500 ready-to-go.

[disneysteve]

Really? I work for an integrated health plan and we are still using colcichine.....I wonder how that works. And how can they give ONE company the exclusive rights to market a drug so long after patent protection expires?

I think what happened was that there are (or were ) a lot of products on the market that were launched long before current FDA regulations existed and they were just grandfathered in. Now, the FDA is trying to clean up the market and eliminate unapproved products, like generic colchicine which has been around forever. Along comes a product like Colcrys, a branded colchicine formulation, that actually goes through the process to get FDA approval. The FDA approves it and yanks all non-approve colchicine products from the market giving Colcrys exclusive rights.

[disneysteve]

As for Mucinex, prior to that product coming out, I used to prescribe drugs like Entex on a daily basis, typically as the generic equivalent. Once Mucinex came along, the other brands and generics all disappeared for the same reason as Colcrys replacing other colchicine products.

[LuckyRobin]

This really makes me angry. I had to be on that drug for ten weeks with my youngest. I can't even imagine if it had cost me that much. And I know this is sexist, but I'll bet if it was a drug men had to take it would never be allowed to cost so much. (I still remember having to fight for birth control coverage when they were handing out viagra like M&M's). I'm getting really sick of all these pharmaceutical companies being in charge of people's lives. Not too pleased with the FDA, either. And while I'm griping I want my Tussalon perles and Albuterol back, too, please. And (different issue, I know) to be able to buy more than 12 12 hour Sudafed tablets at once (because the last thing I want to do when everyone in the family has a cold is drag myself down to the pharmacy every few days).

[disneysteve]

And while I'm griping I want my Tussalon perles and Albuterol back, too, please. And (different issue, I know) to be able to buy more than 12 12 hour Sudafed tablets at once (because the last thing I want to do when everyone in the family has a cold is drag myself down to the pharmacy every few days).

Tessalon and Albuterol are both still on the market so I'm not sure what the problem is there.

I totally agree about the Sudafed products, though. I can't believe there were that many people cooking up meth in their basements to warrant those restrictions. If you are going to put a limit on sales, at least make the limit clinically reasonable. Let people buy a 30-day supply at a time. My wife and daughter both take Claritin-D on a daily basis throughout allergy season. Only being able to buy a few days worth at a time is ridiculous. Fortunately, I'm able to get it through our prescription plan for a 30-day supply but if I had to walk in and buy it OTC, I'd have to go in a few times each month to get enough for both of them.

[jpg7n16]

Lassiez-faire capitalism at it's best and finest.

Was this made as scarcasm saying we don't actually live in a completely free market society?

Or that this is an example of lassiez-faire capitalism at work?


If the first, you've got a point.

If the 2nd- this is actually not free market. These drug company examples are examples of why free market people don't want government intervention on a lot of things. The FDA (a government agency) essentially has created enforced monopolies, and has restricted competition.

An inventors rights should be protected by the gov so that people don't steal his/her work, but if DS said there were suitable generic brands already in place - but are not allowed to be sold because of goverment intervention, then these are clear examples of why free market systems are preferrable to consumers.

Lassiez-faire = minimal government intervention

This pharmaceutical ridiculousness = government intervention

the drug companies can just mark things up 10000% in the name of capitalism and ins. has to pay.

Capitalism encourages competition.

This is not capitalism, this is pure greed.

[minnie1928]

Tessalon and Albuterol are both still on the market so I'm not sure what the problem is there.

I thought Albuterol was supposed to change to comply with some federal regulation regarding CFCs? Is that not the case? I used to take Albuterol, but lately I've been prescribed MaxAir which I believe is a variant of albuterol.

[disneysteve]

I thought Albuterol was supposed to change to comply with some federal regulation regarding CFCs? Is that not the case? I used to take Albuterol, but lately I've been prescribed MaxAir which I believe is a variant of albuterol.

Yes, the actual device was changed to change the propellant - the stuff that makes the drug spray out of the canister. But the drug itself is the same. Instead of Proventil and Ventolin, we now have Proventil HFA and Ventolin HFA, along with ProAir and MaxAir. Many of my patients complain about ProAir not working so well and the device clogging easily, but I've heard no complaints about Proventil or Ventolin.

[minnie1928]

Yes, the actual device was changed to change the propellant - the stuff that makes the drug spray out of the canister. But the drug itself is the same. Instead of Proventil and Ventolin, we now have Proventil HFA and Ventolin HFA, along with ProAir and MaxAir. Many of my patients complain about ProAir not working so well and the device clogging easily, but I've heard no complaints about Proventil or Ventolin.

I've been prescribed the MaxAir the past time or two, but I'm not loving it. I like the canister inhalers because they work with my "thingy" that helps me inhale all the medicine, the MaxAir doesn't.