I know “socialized” medicine is a taboo subject, especially at election time. but if that is what it is going to take in order to fix the healthcare problems in this country then so be it.Â It seems that the capitalist approach does not work when it comes to medicine, and something needs to be done, because while these behemouth corporations, play their games, people are hurt and dying while they are playing them.
I know much of this I have covered in the past… stupid things like, Fat Prejudice in Healthcare (something I have encountered personally in recent events but that is for another post) not to mention things like health insurance companies that take so long to approve a proceedure that the person dies by the time they finally approve it.Â People collapse and are left to die on Emergency Room floors.
But as some people who follow me on Twitter saw last night, my new personal fight on this issue is with MEDCO.Â Medco is another giant corporation.Â They are a “pharmacy benefit management” company.Â In more basic user terms, they are the mail order presription filling company that covers (according to their own information) 1 in 5 Americans.
I have had problems with Medco before,Â back when I was taking medication for my ADD.Â The drugs are considered a controlled substance in New Jersey and you cannot distribute more than a 30 day supply.Â But Medco still insisted that I purchase from them otherwise it would not be covered.Â Â Â However they wouldn’t accept a prescription that had a refill number attached to it, so I had to send a new and unique script every 30 days.Â If it hit their office a day early, they would decline it because 30 days had not passed yet, and this meant a lapse in medication for me lasting anywhere from 2 to 5 days (depending on how weekends landed in the cycle).Â But this is old news now, and not my issue.
No, my issue is that after 3+ years that Medco has been covering my mom’s prescriptions, they have suddenly decided that because the drug is “off script.”Â Since being diagnosed in 1994 with, my mother endured 8 surgeries before the surgeon finally said that she was no longer a candidate for surgery.Â She was presribed a chemotherapy program that proved suprisingly successful.Â For a cancer that was growing at an incredible rate previously, it seemed to come to a stop when she began.Â It didn’t (and doesn’t) actually shrink the tumors as would be the normal hope, but it has suspended their continued growth… for like I said more than 2 years.Â But now some clerk has decided that despite the results, and this being the course of action decided by her doctors, this person has decided that it is not the “right usage”
Now, I’m sorry, if my mom wanted some recreational drug to use, she certainly wouldn’t be taking Temodar and Xeloda.Â Yes, it would be nice if there was something that was designed specifically for her type of cancer, but unfortunately since it is so rare, the chances of putting together a clinical study to get FDA approval is at best remote.
I really don’t like this.Â Not at all.Â Now, we will fight this, the paperwork has already gone in to appeal the decision, and letters have been filed by her doctors.Â But just how long will this process take?Â We were “offered” the opportunity to buy the medication directly… at $4800 forÂ a 12 day supply (which covers 1 month).Â Gee how nice of them.Â But the drug is covered.Â So if it is OK to SELL the drug to us for her to use even though it is off label, then why aren’t they giving it to us covered?Â If they want to complain about how much it costs, they can certainly take up the fight with the pharmaceutical companies, and I would be happy to join that fight as well, because I certainly find it hard to accept $400/dose to be a “fair margin.”
The fight with the pharmaceutical companies will have to wait though, because I can’t worry about that until I know Medco is filling the scripts they should be filling, instead of trying to act like a doctor, or a god, that can just decide from behind some desk who qualifies for what medicine, who lives, and who dies.Â It is a deadly game these people are playing and we shouldn’t have to stand for it.