I watch the ripples change their size
But never leave the stream
Of warm impermanence
And so the days float through my eyes
But still the days seem the same
And these children that you spit on
As they try to change their worlds
Are immune to your consultations
They're quite aware of what they're goin' through

Wednesday, October 21, 2009

Heathcare Links and story

A US Today/Gallup poll on support for Heathcare Reform Bills. While the first numbers look disheartening (33% opposed to 25% supporting it), when you dig down in the numbers at how the 39% "Depends" split make a more nuanced argument. The end result is, if I read these numbers correctly, if the bill includes a "Public Option" the support for such a bill get around 60% approval (as many who said "Depends" are waiting to see if the bill includes a Public Option). If the bill doesn't, that number drops to around 50% (and probably below). The one thing that will kill either option is "Reducing Medicare Payments to Doctors." If that's included, if the bill includes a "Public Option" or not, it doesn't rise above 50% approval. However, in the Senate, a Public Option bill may not get 60 votes. Some of that could be jockeying for favors, but I still think it may be less than 60 (Lieberman and Nelson).

Here's a NPR Report on the war between Big Pharma and Big Insurance. They detail lots of the thrusts each are making against each other. And while the report ends with the thought that the consumers and consumer behavior are the real issue in this battle, I'll also point out that we're the real loser as well. No matter who wins.

Here's another NPR story on how age and gender affects group health care rates. Really, NPR has been doing a bang up job of reporting on this issue. I really wish that this time was also the same as my local NPR Fall Fund raisers (which now seem coordinated between all 3 NPR stations I can receive - ARGH!), so I'm missing a lot of these.

And at this point let me give another personal example of why we need healthcare reform, and not just health insurance reform. My wife takes thyroid replacement pills to adjust for the nuking of her thyroid back in '91 (which is a whole other argument). Now, when you tell a doctor, or someone in the know about these things, the immediate response and drug of (marketing induced) choice is Synthroid. And Bette took this for years. And we didn't know why she was having so many problems and complications. Then, because Bette is the good scientist, she found alternatives and eventually landed on a thryoid pill than didn't make her want to kill herself, Thyrolar. But, and you knew that was coming, Thyrolar and some other thyroid drugs are nearing the end of their patents (which means that generics are possibly right around the corner). So, can you guess what is happening? See, for the past several years the company that makes Thyrolar has only produced the drug in October/November. Usually sometime around August that left us requesting pills from pharmacies other than our usual one. It typically was a scramble to get enough to hold over until the newly minted pills hit the market. So when this happened earlier this year we were ready, and so was the pharmacists.

But, see, something was different this year. The company that produced the drug announced that they wouldn't be producing it this year. Understand, this is a product that sold out every single year. And they were dropping it. Officially their website states that they have to go through new specifications on a component used to make Thyrolar and that's what's causing the delay. So we looked at alternatives, not wanting to go back on Synthroid again (see note above where it didn't work well for her and left her feeling like crap, drugs are like this, for some people they just don't work well). Many of those drugs are also ending their patent protection time and, well, what do you know about that they also aren't being produced (I haven't checked them all, but how much do you want to be they also have the same, "new standards" problem). Only Synthroid continues strong in the market. Now, Synthroid lost it's patent protection a while ago, but if you start googling around for it you'll discover they've been fighting any drug's claim of "bioequivalence." Leaving Sythroid as the number one drug prescribed for thyroid replacement and the number two drug prescribed in the US (over all). And, strangely enough, they don't seem to have the same "new standards" problem. Can you say "monopoly power"?

This is the kind of thing that has me thinking about "structural integrity" and "support points" longingly and wistfully.

7 comments:

WendyB_09 said...

Sounds like they're going to tweak & monkey around with the formula just enough to get a new patent, or extend the one they've got.

Same crap they've been doing with Allegra allery medicine for years. Claritin & Zyrtec were allowed to be released in the OTC market years ago. Not Allegra, they'd kill the goose laying the golden egg if they did that.

I'm allergic to Zyrtec, and Claritin is little better than a sugar pill, but does help a bit. These days I use the OTC generic of Claritin, and sign my life away when I need the extra boost of Sudafed when a decongestant is required.

And every spring, when pollen levels here reach astronomical proportions, hope eternally that Allegra will be released to OTC status. So I can finally get some real relief. As I haven't had insurance in years, it remains out of reach otherwise.

Good luck with the Thyrolar hunt.

Rick said...

Yeah, good luck with the Thyrolar hunt. And, of course, it's not available in Canada.

Unknown said...

I feel the pain....really. Synthroid did NOTHING for me. I found A Doc who listened to me & prescribed Thyrolar( 1993)...worked great! I had a months supply left when I found out I could not get it, I started to panic. I did a lot of research & found some info on Cynoplus. It is supposed to be equivalent to Thyrolar, somewhere between 2 & 3. It is prescribed in Mexico. I ordered 400 tablets for 1/4 the price of Thyrolar. I have been taking them for 17 days...I feel the same...fine. I will continue to take them & if I still feel good I will order 400 more in a few months. Hope your wife finds something that works. The thought of having to take Synthroid was so depressing, I could not see a hopeful future with Synthroid. I am praying the Cynoplus will work for me….forever!

Steve Buchheit said...

WendyB, if I remember correctly, for drug in the same class as Clariton and Zyrtec, the decision to be prescription or OTC is up to the company. Both went OTC as their patents ran out. Clariton works pretty well for me (although it takes about half an hour to start working, but the 24 hour pill usually works most of a day). And around us (in rural Ohio) they really clamp down on the pseudo-ephedrine sales. COnsidering we know about three meth labs just outside our jurisdiction, it's no wonder, but it still pisses me off.

Rick, that's good to know. We are just starting our, "maybe it's available outside the US" searches.

Debbie, it also took Bette a long time to get a doctor to try something other than Synthroid (and even that doctor has all the Synthroid posters in his examination rooms). Cynoplus might be the one drug she talked about that will be the next stop (I remember it started with a "C"). Right now she's on Armor Thyroid, which we had problems with in the past, but she's reduced her dosage and so far hasn't had an issue (had to take her to the hospital last time). But, as she tells me, Armor and the other drug (which may be Cynoplus, but I'm thinking there was an "x" in the other name) are also on "long-term backorder," so whatever stock is out there is all there is. I'd suggest talking with the pharmacists (which I'm sure you already do) to make sure of the constant supply.

I wish you luck as well.

WendyB_09 said...

Believe me, I understand its the federal law and why they enacted it, but what gets me is I get treated like a criminal every time I need to get a single package of Sudafed. If I'm buying one package, this should not be an issue, if I'm buying out the store, yes. Yeah I've tried the new safe pseudo-ephedrine "free" version, it makes my sinuses laugh.

What I really object to is in this day and age of ID theft they have to record a lot of personal info (including DL#). Some stores just have notebooks lieing around full of all the OTC customers detailed information: name, address, phone, DL#, DOB.

Not every pharmacy that is convienent keeps it in stock either. So if I need some, I have to call around, find out who has it, than try to get over there on public transit. A couple chains have streamlined it (Target, CVS), but the rest...painful.

Sad part is the meth labs are now either stealing mass quantities of pseudo-ephedrine right out of the warehouses, or smuggling it up from Mexico & South America. I mean, they busted a HUGE meth lab here just yesterday, I honestly don't know why that house hadn't blown up from all the chemicals in it.

Anonymous said...

I too have been frustrated with Forest Pharm. and the ongoing Thyrolar problem. I have taken Thyrolar for over 40 years and these 'production problems' are something that started only in the last 5-7 years or so.
My doctor tried (insisted) I take Synthroid and within a week my heart rate was in the 40's which is very dangerous. So it was back to Thyrolar and when I can't get it I take Westroid which works very well and as far as I know it's maker has never not produced it. If you Google it you can find the company that makes it and they have an equivalency chart up. I am thinking of changing permanently to Westroid or using a Compounding Pharmacy to make a Thyrolar equivalent for me which I have done in the past. The fact that a Compounding Pharmacy can make Thyrolar easily puts the lie to the statement on the Forest website and phone hot line. I would never knowingly start another drug product made by Forest if there were any other choice. This company cares not one iota about its customers.

Steve Buchheit said...

Westhroid is new to us, thanks Anon. Yeah, the excuse is a weak one. Government agencies don't often make "immediate" changes, they're usually phased in giving industry time to adjust.