I’m not dead! I swear! I just have been busy with work and not drinking myself into a coma.
The Donut Hole.
Those three magic words that all Medicare Part D patients hope they never hear. The gap in coverage where you must pay out of your own pocket for your medications.
I hold Doctors partially to blame for the shit we have to go through when patients hit their donut hole. Before you give me hate-mail-o-rama, lets elaborate:
You have a patient who is on Medicare Part D. Suddenly, all of these new and spiffy trade-name medications are only $3.10! So what does the doctor do? He starts writing for that ARB when a generic ACE-I is okay. He starts writing for Lipitor when the patient has been on generic Zocor for months. He starts getting blowjobs and lapdances from the drug reps in return for prescribing Levaquin when generic Cipro would be okay. “Hell! Its only $3.10! Why not! The patient only pays $1 for generics, whats another $2.10 for a drug that works ‘better’!!!”.
In reality, the doctor is screwing over the patient, big time. In fact, he’s screwing over the patient more than anyone else could. You see, all of those big expensive trade name medications are going on a tab. A tab that pushes the patient further and further towards the donut hole. So their $2400 allotment of ‘coverage’ is now burnt up in 3 months because Mr “Its only $3.10” Doctor switched them all over to trade name medications. How many doctors realize this? About 10. How many doctors care? Zero.. “Its the pharmacists responsibility to take care of this, even though I’ll deny any generic request he submits!”
So who’s sitting there with their puds in their hands. Isnt the doctor, he gets his kick..er..incentives from the drug companies regardless. Its the patient and the pharmacist. The patient because he now has to pay out of pocket for $2,000 or so dollars until he hits “catastrophic coverage”; and the pharmacist because WE have to explain all of this shit to the patient and hear their whining.
Sure we can switch them all back to generics, but its a catch-22. If you switch them all to generics they’ll be in the donut hole longer (because their total cost of drugs per month decreased due to generic switch). If you keep on the expensive trade name medications, they’ll be out of the donut hole quicker, but will pay more per month. Wonderful isn’t it?
In the defense of doctors, they really have no clue how much stuff costs now days. If you’re a doctor, and reading this, the cost of the drug is directly proportional to how many annoying drug reps come and visit you. Why would a drug that cost pennies be pushed so hard by men in suits and women in short tops? Think about it.
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