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View Diary: Dear Mr. President (339 comments)

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  •  Chronic pain, sleep issues, little help from ins (7+ / 0-)

    I have three bad disks, and the pain used to wake me up by 2AM. Oxycodone for the pain would make me less sleepy, so I was up for the day either way.
    My doctor prescribed generic Ambien™, which worked... until about 3AM, and then I woke up. Insurance would not approve more than 10mg/day of Ambien™, and most generic drugs are only 80% as effective as the brand-name product.
    To fix that, he prescribed Ambien CR™, the time-release version that is not available as a generic... it delivered 12.5 mg of the drug through the night, and worked perfectly. I suddenly got enough sleep, for the first time in about three years.
    However, this cost my insurer way too much money. They bombarded my doctor with phone calls, requesting that he change the prescription (He refused). They also tried writing and calling me "to reduce my out-of-pocket costs" ...by switching back to the generic medicine that hardly worked (My responses, especially after the third or fourth try, were not printable).
    Within a few months, my insurer solved their problem by removing Ambien CR™ from their "formulary," the list of medications they cover, and announced this in a triumphant letter that basically said, "We're screwing you out of the medicine your doctor says you need." Back to waking up at 3AM...

    There was a not-unhappy ending: my doctor said, "Your wife is having trouble sleeping also, right?"

    Now, I take one generic Ambien™ at ~10PM, and my wife [ahem] takes half a generic Ambien™ at about 1 AM, and I mostly sleep through the night.

    Of course, if the FDA would approve (and the insurance would pay for) multiple disk replacements, I wouldn't need any drugs. Apparently, dangerous and powerful drugs are cheaper than actually helping me... as long as they're generic, that is!

    "I was never one of those that said Eisenhower was a Commie." -Amos Bush

    by Tom Seaview on Sat Jul 25, 2009 at 03:43:25 PM PDT

    •  I love it! (0+ / 0-)

      There was a not-unhappy ending: my doctor said, "Your wife is having trouble sleeping also, right?"

      My heart medication Coreg, which is the only beta-blocker that worked, suddenly became generic, so the insurance company (through MedCo) automatically switched me to the generic carvedilol.

      I did not want to rock the boat and change my heart medication, so I asked for the brand name.  It was $399.00 for a month's supply.

      I almost paid for it and then I thought of something.  I had my cardiologist call in Coreg CR, which was not generic, so no substitution could be made.

      The brand name Coreg is less expensive to the insurance company than Coreg CR, so it was their loss.

      Knowing that most people experience things like this, it is laughable that there is even a "debate" about health care reform.

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