Friday, September 19, 2008

Liz . has a different Take on the Dr-Pharmacist Issue

David:

Your interpretation may be correct.

George Abbott's protestations to the contrary, however, I read the proposal differently. I think it was a back-handed attempt by the Liberals to take doctors' visits off the healthcare system and load the fee on at the drug store.

The Minister says not, but drug stores are not into losing money. So if Abbott is successful in squashing the fee, the pharmacy will just build the cost into the price of the prescription.

I support doctors on this, and here's why...

The current system, as you point out, requires a patient to visit the doctor to have a prescription renewed beyond the number of repeats indicated on the first label. A costly, unnecessary nuisance? Maybe - but only if an innocuous med is being prescribed.

For anything more, the BCMA has a valid point - even if it does provide income for the prescribing physician.

Today's medications are hi-tech stuff. Almost daily, we hear of newly-discovered, sometimes life-threatening side effects of meds that have been on the market for years. In some cases, that unnecessary visit to the doctor can save your life...

Conflicts with diet or other meds; doubling-up by patient visits to more than one pharmacy; undesired side-effects, drugs not achieving the relief for which they were prescribed, embarrassing results a patient will not discuss in a busy drug store. There are endless reasons why that doctor's visit would be a better way to go.

All of that said, there's a far more important aspect to the Pharmacare problem that is never really thrashed out...

IF GOVERNMENTS WANT TO SAVE MONEY IN THE HEALTHCARE SYSTEM, WHY ARE THEY SO UNWILLING TO TACKLE THE CORE PROBLEM - THE COST OF THE DRUGS IMPOSED BY THE MACHINATIONS OF THE MANUFACTURERS AT THE TOP OF THE CHAIN? To illustrate...

Following a bout of food-poisoning about five years ago, a patient was left with a chronic case of gastro-esophageal reflux - GERD. Left untreated, a GERD patient is not only very uncomfortable, the condition can lead to cancer.

The modern, very expensive, blitz-advertised remedy is what, for legal reasons, I'll call the sexy-pill. The sexy-pill was initially prescribed to our patient.

It did not effect a cure within the "usual" eight weeks. A visit to the doctor suggested other, less expensive, options. The patient demurred, reluctant to change from said sexy-pill, which had given great relief, despite no cure.

Incredibly, the doctor explained thusly: "This alternative, in all ways that matter, has the same ingredients. What you need to know is that the manufacturer of the sexy-pill initially produced a similar med, same medicinal ingredients...but the patent-protection period was coming to an end. Had that happened, any company would have been free to produce it, and the price would have dropped dramatically. So the manufacturer added a few mean-nothing ingredients, changed its appearance, re-patented it for another ten years, and Presto! the sexy-pill was born. And it is now sold at an even higher price."

When our patient expressed surprise and disgust, the doctor replied, "It happens all the time -all throughout the pharmaceutical industry, and the legal rights of the patent are costing us bigtime. How else do you think they can afford to give me this box of sexy-pill samples."

When I heard about this, David, I began to do some research which, sadly became overwhelmed by other projects. Suffice it to say - other countries, many of them poor countries, have found ways to combat this...ways that, if duplicated in North America, would save patients and governments alike BILLIONS of dollars.

Likely to happen? Don't hold your breath.

Liz J.

September 19, 2008