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Physician Suggests Ways To Fix Medicare Part D

Twenty seven million individuals were enrolled in Medicare Part D as of December 2009. The government spent $51 billion to subsidize Medicare Part D in 2009. The $51 billion spent is in addition to seniors’ premiums and co-pays. The government subsidy was $1,889 per individual subscriber.

Who is making the money?

“A provision in the Medicare Modernization Act (MMA), known as the “noninterference” provision, expressly prohibits the Medicare program (the government) from directly negotiating lower prescription drug prices with pharmaceutical manufacturers.”

This was a gift to the healthcare insurance industry by the government as a result of intense lobbying efforts.

Over 300 private plans (Medicare Plan D sponsors) enter into negotiations with pharmaceutical manufacturers separately to deliver Medicare Part D benefits.

Medicare Part D eligible seniors are forced to deal with Read more »

*This blog post was originally published at Repairing the Healthcare System*

Physician Discusses The Confusing Aspects Of Medicare Part D

I have discussed Medicare Part B and Part F in recent blogs. A reader asked about Medicare Part D:

Dr. Feld

“Please discuss Medicare Part D, the drug benefit plan available to seniors. It is very complicated and completely confusing to me.

My physician gave me a prescription for Levequin 500 mg once a day for 10 days. The pharmacist told me it would cost me $330 dollars. Medicare Part D would pay an additional $110 dollars for a total of $440 dollars.

I asked the pharmacist if there was a generic equivalent. The answer was yes. It cost $10 dollars.

This is unconscionable. It is highway robbery.



Several issues are presented in this readers note. It is essential to understand these issues. The issues are an indictment against government “controlled” programs. Read more »

*This blog post was originally published at Repairing the Healthcare System*

Is The Young Pharmaceutical Rep Right?

I loved my old status. Perhaps, reveled in it would be a better description. I was a crotchety, generic medicine-only doctor.** Sadly, my status changed today. Dabigatran (brand name Pradaxa) was the culprit.

It was a little nerve racking. I wrote the order, looked at it, thought it out again, talking to myself: “John, are you sure you don’t want to do it the old way? [pause to think] No, I am embracing the new.”  And then, I closed the chart and handed it to the nurse.

“What’s that? Pradaxa?” asked the nurse. “Stop the Lovenox? You sure?” My face must have told the story.

Eight days had passed since dabigatran’s approval. “That’s plenty of time to mourn warfarin’s demise,” I thought. Enough studies, enough blogs — it was time for the rubber to hit the road. Read more »

*This blog post was originally published at Dr John M*

Top Gripes About Drugs And What They Cost

I used to defend pharmaceutical companies. ”What companies out there have contributed more good? Should care manufacturers make more when all they do is make transportation that breaks after a few years?”

It made sense to me that you should put a pot of gold at the end of the rainbow so that companies are motivated to invent more drugs and innovate. We throw a lot of money to athletes and movie stars who simply entertain us, shouldn’t we do better to those who heal us? I used to say that. I don’t anymore.

No, I don’t think the drug companies are “evil.” People who say that are thinking way to simplistic. These companies are doing exactly what their shareholders want them to do: make as much money as possible for as long as possible. That’s what all companies do, right? They are simply working within the system as it is and trying to accomplish the goal of making money. To say that they should “sacrifice” is foolish. They are simply playing by the rules that have been set out there. Those rules are the thing that has to change. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Generic Drugs: Not So Cheap

I received the following e-mail from a patient (paraphrased):

Dear Dr. Fisher,

Thank you for trying to switch me from lisinopril to generic losartan (Cozaar) to help me with the irritating cough that has been nagging me since I was placed on lisinopril. I did not pick up my prescription, though. At nearly $200 for a three-month supply, I’ve decided to live with the cough, since the same amount of lisinopril costs me about $12.

-Ms. Patient

Interesting how the generic drug market for some drugs only marginally discounts prices. Since the companies that make generics did not have to absorb research and development costs, how do they justify the exorbitant prices? Simple: The middlemen still have to get theirs.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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