Tag Archives: medication

Writing Prescriptions Without Medical Basis

Opioid Prescriptions Without Medical Basis– by Gigen Mammoser – Sept 2018

A new study has found that, in a startling number of visits to a physician between 2006 and 2015 when an opioid was prescribed — nearly 30 percent — there was no recorded indication for pain.

The study, published this month in the Annals of Internal Medicine, highlights a potential administrative problem among physicians who prescribe opioids, and a need for better documentation practices

What did the study find?

In the study, opioids were found to be prescribed in 31,943 visits, of which only 5 percent documented a cancer-related pain diagnosis.  Continue reading

Report adverse or no medication effects to the FDA

MedWatch Voluntary Reporting Form – for reporting adverse drug effects to the FDA

Perhaps the FDA doesn’t know how ineffective “alternative” non-opioid drugs are for pain because no one has told them. You can download a form from this site (link above) to report your experiences.

Use the MedWatch form to report adverse events that you observe or suspect for human medical products,including

  • serious drug side effects,
  • product use/medication error,
  • product quality problems, and
  • therapeutic failures

It’s this last category that presents our opportunity for action. We could report the “therapeutic failures” and awful side-effects of non-opioid medicaitons like Lyrica, gabapentin, or antidepressants for pain. Continue reading

Anticonvulsants May Be Ineffective for Back Pain

Anticonvulsants May Be Ineffective for Low Back, Lumbar Radicular Pain – Hannah Dellabella – Sept 2018

Many pain patients cut off from the relief opioids provided turn to prescriptions of these “maybe they’ll work, but they probably won’t” non-opioid drugs in desperation for some relief of their intractable pain.

From what I’ve heard, these drugs have serious cognitive side effects (memory, concentration) and are usually not effective. I use Lyrica to tamp down the spread of pain flares, but it has zero effect on my usual nociceptive pain from EDS.

For this systematic review, investigators searched 5 databases from studies examining the effects of an anticonvulsant compared with placebo in participants with nonspecific low back pain, sciatica, or neurogenic claudication of any duration. Continue reading

FDA Investigating Misuse, Abuse of Gabapentinoids

FDA Investigating Misuse, Abuse of Gabapentinoids – by Joyce Frieden, News Editor, MedPage Today – February 15, 2018

Gabapentinoids such as pregabalin (Lyrica) as well as the original agent gabapentin (Neurontin) are approved to treat a variety of conditions, including post-herpetic neuralgia, fibromyalgia, and neuropathic pain associated with diabetes, and

“some literature suggests that clinicians may be prescribing these drugs off-label … as alternatives to opioids, outside approved indications,” Gottlieb said.

Desperate times call for desperate measures.  Continue reading

Study Shows How Aspirin Fights Inflammation

Study Shows How Aspirin Fights Inflammation – National Pain Report

A daily low-dose aspirin has long been recommended by doctors for its cardiovascular benefits.

But only now are researchers getting a better understanding of how aspirin reduces the inflammation that can lead to heart disease and other chronic health conditions.

So, doctors were recommending something even though they didn’t know its mechanism of action. I always thought it worked because it thinned the blood.    Continue reading

How To Save Money on Your Rx Drugs

Are You Paying Too Much for Your Drugs? – Aug 2018 – by 

Health care in America is expensive. One of the biggest costs? Your medications.

A recent study from researchers at the University of Southern California highlighted part of this expensive problem. Based on their analysis, 23% of customers overpaid for their prescriptions. Nobody will tell you you’re overpaying, not the pharmacist — who might not be allowed — and certainly not your insurance company.

If you’re one of the nearly 50 percent of Americans who’s taken at least one prescription drug in the last 30 days, it probably won’t surprise you that 16.7 percent of healthcare spending in 2015 was on drugs alone. That’s a total cost of about $457 billion annually, and the prices aren’t going down any time soon.

Here’s how you might be able to save money on your drug costs, even if you’re covered by insurance.

Work With Your Doctor (and Pharmacist!)

Sometimes when clinicians prescribe medication, they have choices about the specific brand or generic they give you that can make or break your budget, depending on the cost.

If your doctor wants to prescribe something that isn’t covered, ask if there’s a similar medication or generic version that is covered.

If you need a medication that is more expensive or not on the formulary list, your insurance company may require you try step therapy before approving your drug of choice.

And buyer beware. Sometimes pharmaceutical companies offer doctors financial incentives to prescribe particular drugs. This may not be in your best medical or financial interest.

If you need help sorting through your option, try asking your local pharmacist. They know just as much, if not more, about drugs as your doctor.

But they know nothing of me, and it’s my personal biochemistry and medical history that usually determines the effectiveness of any particular medication – and the pharmacist has no access to any of that.

Choosing a Generic Medication

n the U.S., drug companies can patent new drugs for 20 years, which means patients prescribed those meds are stuck paying brand prices. This system is partly why your drug costs are so high in the first place.

Once that time period ends, other companies can make a generic version that sells for much less. One of the best ways to save money is to switch to the generic version of a medication.

While there’s been some debate in the media about whether or not generics are as good as the brand, most concerns are unfounded.

I have my doubts about the quality control of generic medications and the equality of different generics.

My experience has been that sometimes when my pharmacy gets their generics from a different vendor, that generic will affect me differently than the previous one I used or the brand name medication.

Generic drugs are regulated by the Food and Drug Administration and must have the same active ingredients as the brand version.

However, one critical difference is that:

The non-active ingredients in a generic don’t need to be the same.

These non-active fillers determine how much and how fast your body can metabolize the medication, so they are a critical component of how the drug works in our individual bodies.

Medication Therapy Management Programs

If you’re on Medicare, you might have heard of a medication therapy management (MTM) program.

An MTM helps you review the medications you use if you have more than one chronic condition. With a pharmacist and/or your doctor, you’ll check to make sure the drugs you’re taking work effectively.

doctors prescribe new drugs each time symptoms occur. Eventually, it’s hard to tell what you’re taking and why. An MTM evaluation can help consolidate prescriptions so they’re more effective and cost-efficient.

Manufacturer Assistance

If you can’t afford your prescription, you can try reaching out to the drug company directly. Drug manufacturers often offer some version of a prescription assistance program for those can’t afford their medications

Drug company Pfizer, the manufacturer of drugs such as Lyrica, has a RxPathways patient assistance program.

After searching for the medications you take and answering a few personal questions, including your monthly income, you’ll find out if you’re eligible for discount meds.

In the case of Pfizer, if you do meet the income requirements, you can apply to receive free Pfizer-brand drugs at your doctor’s office, home or by using a discount co-pay pharmacy card.

Price Shopping to Get Your Drugs for Less

you can shop around for your medications just like you would any other product.

This means not only checking out a variety of pharmacies or big box and club stores, but also your options available through discount prescription services like ScriptSave WellRx and FamilyWize.

Discount prescription companies negotiate rates directly with drug companies. Often you can get a better rate through one of these services than what you would pay in cash — and sometimes better than your cost with insurance.

You might need to print out a savings card or coupon to present to your pharmacist. Some companies let you order directly online or send medications straight to your house.

Here are six discount prescription services:

Please see the full article for the list and description of each.

How Much Can You Save?

We asked the Mighty community which prescription drugs they have a hard time affording — and more than 500 people shared a variety of costly prescriptions.

Based on the community’s answers, we pulled four common drugs — Abilify, Savella, Remicade and Pristiq — and did a little price shopping.

We compared the average amount you paid, which included brand and generic drugs, with how much you might be able to save (based on calculations in Los Angeles).

Abilify (Aripiprazole)

Abilify is an antipsychotic used to treat conditions such as schizophrenia, bipolar disorder and depression. Brand and generic versions are available. The brand version can cost as much as nearly 95 percent more than the generic version based on these discount prescription services.

Savella (Milnacipran)

Savella is a nerve pain and antidepressant medication often used to treat fibromyalgia. Currently, only the brand version is available.

Remicade (Infliximab)

Remicade is an immunosuppressive drug used to treat conditions such as rheumatoid arthritis, Crohn’s disease and ulcerative colitis. It is only available as the brand version, though two similar medications, Inflectra and Renflexis, have been approved by the FDA.

Pristiq (Desvenlafaxine)

Pristiq is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) used to treat depression. Currently available in both brand and generic variations. The generic version costs about 20 to 30 percent of what the brand costs based on these discount prescription services.

Author: Renée Fabian is Associate Editor, News & Lifestyle at The Mighty.

AMA Rejects Time Limits On Opioid Scripts

American Medical Association Rejects Idea of Time Limits On Opioid Scripts – by Bill Meagher – Apr 2018

In the midst of an epidemic of opioid use that caused almost 32,000 deaths last year, the American Medical Association is pushing back against a wave of legislation that sets limits on doctors prescribing the pain med.

Dr. Patrice Harris, the chairwoman of the AMA‘s opioid task force, says her organizations has grave concerns about

  1. limiting a physician’s ability to prescribe medication that a patient might need and that
  2. decisions on how a doctor treats a patient is best left up to them.  Continue reading

FDA Investigating Misuse, Abuse of Gabapentinoids

FDA Investigating Misuse, Abuse of Gabapentinoids – by Joyce Frieden, News Editor, MedPage Today – Feb 2018

Here comes another round of addiction hysteria, this time about medications doctors are prescribing on the slim chance they could help suffering pain patients for whom they are no longer allowed to prescribe opioids.

The FDA is looking at whether gabapentinoids are an addiction threat, FDA Commissioner Scott Gottlieb, MD, said Thursday.

Gabapentinoids such as pregabalin (Lyrica) as well as the original agent gabapentin (Neurontin) are approved to treat a variety of conditions, including

  • post-herpetic neuralgia,
  • fibromyalgia, and
  • neuropathic pain associated with diabetes,

Continue reading

Why a patient paid a $285 copay for a $40 drug

Why a patient paid a $285 copay for a $40 drug | PBS NewsHour – By Megan Thompson – Aug 2018

Liu and her husband Z. Ming Ma, a retired physicist, are insured through an Anthem Medicare plan. Ma ordered the telmisartan [prescribed after transient ischemic attack]through Express Scripts, the company that manages pharmacy benefits for Anthem.

The copay for a 90-day supply was $285, which seemed high to Ma.

…during a trip to his local Costco, Ma asked the pharmacist how much it would cost if he got the prescription there and paid out of pocket.

The pharmacist told him it would cost about $40.   Continue reading