The
way we dispense medication in the United States is
changing as we speak.
Concerned about the new Medicare drug program, major
drug chains are turning to distributing cheap, generic
drugs to combat possible low Medicare reimbursement.
How do I know this? I recently spent three hours with
my doctor and pharmacist, trying to figure out how I
could get my regular medication, which is being
discontinued. It gave me a glimpse of what millions of
elderly and other chronic medication-users could go
through soon.
My usual pain medication is a good generic called
Endocet, used in place of Percocet. Endocet is a mixture
of oxycodone and acetaminophen. A couple of months ago,
my doctor heard about a cheaper generic and thought I
should try it. I went along, figuring one generic is as
good as the next.
Both of us couldn't have been more wrong. I had no
relief from this new generic drug and was in constant
pain. I thought I had to adjust to the new medication,
which can take up to two weeks. But at the end of the
month I had a long talk with my doctor, and he switched
me back to Endocet.
To understand the difference between brand name and
generic drugs, consider Crisco. Many other shortenings
claim to be just as good and to use exactly the same
ingredients. But the processing of the ingredients makes
Crisco a better product. The same goes for brand-name
drugs versus generic.
When I went to get my refill of Endocet this month, I
was told that the drug chain found a cheaper version and
will no longer carry Endocet. The cheaper generic does
not contain acetaminophen but is being touted as the new
generic for the brand-name Percocet.
I had to go back to my doctor to get him to reissue
my prescription for Percocet. I complained to the
pharmacist about the removal of Endocet, the good
generic. She told me this was done in preparation for
the new Medicare drug program, out of concern that the
drug chain doesn't know exactly how much it will be
reimbursed. This is bad news for those who cannot
tolerate the cheap stuff.
This reminds me of a practice that began with the
medication Prilosec, used for the treatment of
acid-reflux disease. When the U.S. Food and Drug
Administration allowed it to be sold over the counter,
pharmacies began using the over-the-counter dosage to
fill prescriptions for insurance payments that still
covered prescription Prilosec. Boxes of Prilosec
disappeared off the shelves. It was cheaper for the
drugstore to use the over-the-counter Prilosec and bill
insurance companies at the prescription-only rates.
Next time, my doctor will have to mark my medication
"as written" on the prescription - meaning no
generics. This will raise my drug costs and my insurance
rates.
Misery flows downhill. Unfortunately, I'm at the
bottom.
