One of the hardest parts about working in a pharmacy is watching patients having to choose between medicine and a meal on the table every night. Yes, there are financial assistance programs like the PPA (one of my favorites, by the way) or manufacturer programs, but in many cases patient’s don’t qualify for them because they earn just a little too much money.

Never mind that insurance premiums and copays keep going up, and insurance companies keep adding or expanding deductibles so patients have to pay out of pocket until the deductible is reached.

I have one patient that gets Altace (ramipril), which is an ACE Inhibitor. She has prescription coverage, but her insurance won’t cover it because there are much cheaper generics in the same class. We called the doctor to get the drug changed, citing cost reduction, and the doctor was practically incensed that we would even suggest it. “Have you tried prescribing a generic yet?” we asked. (Of course not, those studies that the Altace people gave her showed that it works much better.)

So, instead of paying $4 a month for generic lisinopril (or slightly more for fosinopril or benazapril) She has to pay almost $60. (when she can afford it.)

There’s also Merujo, a fellow blogger I met at the January dc blogger meetup. She has a problem in her eye where the blood vessels are growing exponentially, causing her loss of vision. She is being treated with injections of Avastin, a drug used to treat colon cancer. But, since the drug isn’t approved for this use, her insurance won’t cover it. So Merujo is faced with a choice: Go broke or go blind…

Sometimes, I wish I could just take out my credit card and pay for a patient’s meds myself, but of course if I did that, I’d go broke too. We really need to do something about the medical care in our country. I just don’t know what…

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