Budget-busting prescription drugs

Taxpayers footing the bill

I watched this on my local news the other night: Runaway drug price hikes squeeze Washington’s budget.

Our state is one that expanded Medicaid under the Affordable Care Act (ACA), so I knew we were spending a lot. But I had no idea now much. Through the first 9 months of 2016, my state has spent $1.1 billion on prescription drugs.

Not total medical care. Just prescription drugs.

And Washington is not the only state facing a fiscal nightmare because of skyrocketing drug costs.

Almost half of that spending is for the really high-priced specialty … Continue reading

Choosing Wisely – Use less healthcare

My goal for 2017? Use as little healthcare as possible

How will healthcare change under a new president and political party?

That’s a question I can’t answer. As I wrote in my last post, both candidates had multiple-point plans to tweak/improve/repeal/replace the Affordable Care Act, aka the ACA or Obamacare.

But I don’t know what will change or when.

What I know for sure is that for 2017 my premiums will be 20% more expensive, my co-insurance and co-pays will be higher, and my current primary care doctor will no longer be in-network.

I can and will shop around … Continue reading

Election day and healthcare 2016

american-flagI started this blog four years ago, the day after President Obama won the general election. I needed an instrument to give voice to my frustrations and fears about the direction of our country’s health and healthcare policy.

I just re-read what I wrote back then:

So, the Affordable Care Act (ACA or Obamacare, as it’s commonly known), having survived its precipitous birth and a few close-calls with death, is poised to enter a prolonged and awkward adolescence.

I am not a huge fan of Obamacare because it seems to be more health insurance reform than health care reform.

Continue reading

Outrageous cost of EpiPens finally getting some attention

Wow. Talk about timing.

I just posted a few weeks ago about my dread of renewing my EpiPen prescription because of its cost—over $700 without insurance, and still over $600 with my insurance!

It seems other healthcare advocates, the media, Congress and even the presidential nominees are at last realizing how insane it is to charge that much for literally a few cents worth of epinephrine.

EpiPens are not even new to the market, like so many other high-priced drugs. It’s been around for a long time, so Mylan pharmaceuticals can’t claim it’s trying to recoup R&D costs. In fact, … Continue reading

View Prevnar 13 ads with caution

prevnar 13Prevnar 13: As seen on TV

I was watching TV the other evening and, as usual, was forced to sit through multiple back-to-back prescription drug commercials.

One that caught my attention was for Prevnar 13, which is one of the pneumonia vaccines. (13 because it protects against 13 strains of streptococcus pneumonia.)

The commercial stated Prevnar 13 was for adults aged 50 and older.

That statement’s true, but needs some clarification.

Yes, Pfizer did get FDA approval a few years ago to market Prevnar 13 to adults over the age of 50. Previously, the vaccine was only used for … Continue reading

EHR – Electronic Hell Records

Healthcare Not Fair is a satirical YouTube video series created by a real-life physician, Dr. Waqas Khan, to highlight problems within our broken healthcare system.

Their latest video takes a stab at electronic health records, EHR—or, as they call it, Electronic Hell Records!

Other videos by Healthcare Not Fair:

I just saw my primary care physician a few weeks ago, and I can relate to the fictional patient’s experience in the video. Receptionists really do keep their eyes glued to their computer screens!

My physician isn’t that bad, … Continue reading

Skin cancer screening guidelines

skin cancer“Insufficient evidence”

Many years ago I had a primary care doctor who used to perform a total body skin examination (TBSE) on me every year as part of my annual exam.

Of course, those all-inclusive physicals are a thing of the past. I haven’t had a physician perform a TBSE for a long time.

I often wondered about that. A TBSE seems like a relatively easy and harmless way to quickly screen for skin cancer. The goal, of course, is to find a melanoma, the deadly skin cancer, when it’s small and possibly curable.

Related post: A must-watch video about Continue reading

The high cost of healthcare in America

They say a picture is worth a thousand words, and the online news site Vox recently sought to open Americans’ eyes as to how much more we pay for healthcare compared to other countries.

America’s healthcare prices are out of control. These 11 charts prove it.

I can’t copy their charts, but basically they are bar graphs. The bar that shows how much patients in the US pay for similar drugs and services towers over the others like a skyscraper over a neighborhood of single-family homes. Like this:

healthcare costs graph

Vox got its information from the International Federation of Health Plans (IFHP)Continue reading

Obamacare premium increases for 2017

Up, up and away!

Does anyone’s income go up as fast as their health insurance premium? I wish.

11.6%. That’s how much more my current health insurance provider wants to charge for my bronze high-deductible health plan in 2017.

And although 11.6% seems like a lot to me, another company in my state is requesting a 19.9% average increase on all its plans, with a 28% increase on its gold plan!

So far, the rate increases that have been made public in other states are all pretty high, averaging well into the double digits. So at least I’m not … Continue reading

“End of the Line” for medical guidelines

Knowledge is king

That’s the take home message from Professor (of pharmacy) James McCormack’s latest parody video, End of the Line, which takes a whack at healthcare’s increasingly pervasive and rigid medical guidelines.

 

If followed to the letter, these guidelines (often based on research funded by drug companies) would have everyone diagnosed with a disease and taking one or more medications. Medical guidelines may be great for the drug business, but not so much for individualized, patient-centric care and shared decision-making.

Chronic disease state guidelines (blood pressure/lipids/glucose/bone density) do not provide clinicians with

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Screening eye exams in older adults

Just yesterday I posted about the United States Preventive Services Task Force (USPSTF) and the fine line they walk between providing evidence-based recommendations for screening tests and making medical specialist groups happy.

Sometimes it just doesn’t happen.

The task force recently gave an “I” grade to vision screening in patients over 65. An I grade, or Insufficient evidence, means that the task force can’t definitively say that the benefits of vision screening in older adults outweigh the possible harms.

The American Academy of Ophthalmology (AAO) doesn’t agree.

Specifically, the task force reviewed the evidence for primary care doctors screening for … Continue reading

Are Health Care Loans a good idea?

Not in my humble opinion.

I just read about this idea proposed by health financing researchers out of MIT and Harvard: Financing health care with consumer loans.

They begin their article with what we all know—health care, specifically prescription drugs in this case, costs too much.

We propose a practical way to increase drug affordability through health care loans (HCLs)—the equivalent of mortgages for large health care expenses. HCLs allow patients in both multipayer and single-payer markets to access a broader set of therapeutics, including expensive short-duration treatments that are curative.

When they talk about “curative” drug treatments, they … Continue reading

Will Congress fight the high cost of prescription drugs?

Last November, with much media coverage, several members of Congress announced the formation of The Affordable Drug Pricing Task Force, promising to “take action to combat the skyrocketing costs of pharmaceuticals.”

Finally! I thought.

Related post: Prices continue to increase for generics

But I haven’t heard much since then.

There was a little noise earlier this month when the House Oversight Committee (of which the task force is a subcommittee, I believe) attempted to grill the now infamous Martin Shkreli about why he thought it was okay to jack up the price of Daraprim from $13 a pill to … Continue reading

The “financial toxicity” of cancer

We’ve all heard the phrase “cancer kills.”

But guess what? So can the high cost of treatment.

I just read about a study that came out of the Fred Hutchison Cancer Research Center here in Seattle.

The results won’t surprise anyone familiar with how much cancer treatment costs (a lot!), but researchers found:

…cancer patients who go bankrupt are nearly 80 percent more likely to die than patients who don’t, and some cancers had significantly higher mortality rates. Prostate cancer patients who filed for bankruptcy were almost twice as likely to die; bankrupt colorectal cancer patients were 2.5 times more

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The high cost of dementia

November is Alzheimer’s Disease Awareness Month.

It’s hard to find anyone who isn’t aware of—and scared of—dementia**. Or who hasn’t had a family member or friend stricken by it.

Alzheimer’s is a horrible disease that damages not only the individual, but family and friends, as well, especially the primary care giver—most often the spouse.

Adding insult to injury is the incredible cost of getting help. A recent study published in the Annals of Internal Medicine confirms what many already know—Alzheimer’s disease and other forms of dementia cost families way more than almost any other disease.

Why? Cancer is one of Continue reading