Affordability – ha !


Can I tell you how much hate debating Rx costs and brands with the pharmacist?  Last year, they changed my branded Xopenex inhaler to Levabuteral (generic) in virtually identical packaging, that almost killed me.

So, the whole debate over brand medicines versus generic medicines is something that only a qualified individual should determine (and I am neither a pharmacist nor a doctor, the two people who should be having the necessary conversation).

Anyway, even though I refuse to allow my pharmacist to have my phone number (because they love their robo-caller), the phone number is buried in the “notes” section of my account, and a determined pharmacist can find it if he or she wishes.

He wished.  I got a voicemail indicated that they could not fill my “Glucophage” Rx because it costs between $4,000 and $5,000 and is restricted by my insurance company, and would I allow a substitution.

Moi ? ! ? ! ?

Why aren’t you talking to my doctor vs. me?  I am not debating the merits of various medicines, but I will have a conversation with my endocrinologyst about what is and is not affordable.  So, I send a message to the doctor, and she’s telling me that she prescribed EXACTLY the right thing, “Glumetza”, and did I want her to get a pre-approval for the medicine?

Glumetza cost

Heck, no !

Glumetza for 60 tablets (and she would like me to try it for a month for 90 tablets) is outrageously priced.

So, I sent yet another email off to clarify the different names of the products being referenced (Glucophage is about $113 per month), and asking her to clarify with the pharmacist if “Glucophage” is a reasonable substitute for the “Glumetza” she originally specified.

I’m at the end of life folks, finding it tough to afford everything.  If you think I need at $6k medicine (or even a $2k medicine) each month, then you value my life a heck of a lot more than I do.

Yes, the metformin is improving my liver enzymes.

Yes, the metformin is causing explosive bowel movement issues.

I’ve already cut back on the metformin and removed all herbal supplements possible to mitigate some of the side effects.

My next choice is to do without the medication recommended if you think that switching it to a more-expensive-than-gold Rx is a reasonable solution.

As referenced in the book by Atul Gawande, “Being Mortal”, I don’t want to spend the last bits of my life worried about how I’ll afford to live, and scared of the costs of my medicines.

07SCIB-master315 beingmortal1

People lived for millions of years without these expensive Rx’s, and I see little value to foolishly expend insurance resources that are unaffordable.  I am not Rockefeller with limitless income, and I accept that my entitlement to care comes with some reasonable caveats.

If the medicine is causing a side effect trying to resolve a problem, then one eliminates the unaffordable solution AND the medicine causing the problem.  One does not believe that they are entitled to exhaust insurance dollars which are better spent on children and young adults when we already know that we are simply delaying the inevitable biological breakdown in my particular case.


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