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I'd like to rant for a minute of your time; insurance companies that play doctor
Topic Started: May 18 2007, 10:17 AM (344 Views)
plays88keys
Pisa-Carp
I have a well-documented history of depression that goes back to adolescence and is something that seems to run in my family. The condition has been managed quite nicely in recent years by taking the brand name drug Wellbutrin XL.

My health insurance now requires that long term drug treatments be filled by mail order only. Each written prescription lasts for one year and is dispensed in 90 day supplies. Until now it's been a nusiance to comply, but not an inconvenience, and each 90 day supply can easily be refilled online at the insurance website. That is, until this January, when it was time to get a refill on a prescription that was submitted to them in the Fall and should have lasted for a year.

Some insurance person sitting in a cubicle somewhere far, far away from both me and my doctor decided that Wellbutrin XL cost too damn much money and switched my prescription from the brand name drug I've been successfully taking for more than three years, without any incident, to a generic that had been on the market a grand total of 15 days.

I was immediately alarmed. My WB XL tab is about the size of a regular dose of aspirin, and this thing was the size of a big, honkin' Centrum multivitamin. How could this possibly be the same drug or even it's equivalent? An insert with the mailer screamed "Good News about your prescription!" and proceeded to tell me that they had contacted my doctor for permission to switch my medication. Excuse me, but I'm the one that takes the meds, so why was I not contacted by either the insurance company OR my doctor??? :mad2:

When I phoned the doctor's office with this question, his nurse called me back with his reply. Yes, he approved the switch. Take it for the duration of the vial (90 days) and if I don't like it, he would re-write it as "dispense as written." I took it. I hated it. It made my whole body tense up, with resultant nausea and tension headaches and grinding my teeth. Finally I'd had enough suffering and I called the doc and complained. I was told to stop taking it, come to the office and pick up the rewritten prescription. No problem...except I had to wait two days before he'd written it. So...two days down without any medication.

I mailed the prescription to the f*cking insurance company last Thursday and checked off the FedEx option to get it to me ASAP. All this week when I went on the website to check on it it was listed as "pending approval." My guess is they balked at sending me what works effectively and best for me and tried to weasel out of it...finally to no avail. It was sent out via DHL on Wednesday evening.

I was going to rant some more but the meds just arrived and I've taken one. But still...12 DAYS WITHOUT MY MEDS. My moods have been all over the map.

Who would have been liable if I'd gotten suicidal and hurled myself off a building?? :mad2:

I HATE INSURANCE JERKS WHO PLAY GOD/DOCTOR WITH MY HEALTH!!!


[size=1]thanks for letting me rant...[/size] :leaving:
You can never get enough of what you don't need to make you happy.
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George K
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Finally
What the HELL is wrong with you???

If it's cheaper, it's better! Get that through your head! We know what's best, and you have no business complaining. It is, after all, all about saving money for you, right?

(George - who asked the administrator of the OR. "When you come to have your surgery, which endotracheal tube do you want, the cheapest or the best?")

Another similar story happened with Mrs. George and her thyroid. She's been on "Synthroid" for 20 years. All of a sudden, she's sleeping all the time, gets bloodwork - thyroid level unmeasurable. Guess what, they changed to generics.

Bastards.
A guide to GKSR: Click

"Now look here, you Baltic gas passer... "
- Mik, 6/14/08


Nothing is as effective as homeopathy.

I'd rather listen to an hour of Abba than an hour of The Beatles.
- Klaus, 4/29/18
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plays88keys
Pisa-Carp
George K
May 18 2007, 02:24 PM


(George - who asked the administrator of the OR. "When you come to have your surgery, which endotracheal tube do you want, the cheapest or the best?")


Love that, George!

Wouldn't it be great to do that to every insurance person who makes these decisions for the rest of us?

OR...generic form of novacaine that wears off on insurance jerk in the middle of a root canal... :devilgrin:
You can never get enough of what you don't need to make you happy.
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Kincaid
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HOLY CARP!!!
Plays, what is the name of the generic you to which you were switched? What strength is it?

Generic Synthroid does cause a lot of problems - no one seems to know why but it is one of the worst offenders.
Kincaid - disgusted Republican Partisan since 2006.
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plays88keys
Pisa-Carp
Kincaid, I know you work in the insurance industry and I like you, but some of these decisions you guys make about how best to manage another person's health just plain stink.

The generic is something called budeprion xl 300 mg. It's more than twice the size of the Wellbutrin tab.
You can never get enough of what you don't need to make you happy.
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Kincaid
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HOLY CARP!!!
Here's a link to check if the size/appearance matches what you are supposed to be getting. I handle pharmacy claims and misfilled drugs do happen. Unfortunately, the photos don't show size comparisons.

http://www.ahealthyme.com/DrugInfoAction.d...gname=Bupropion

It is strange that the size would be so different. I would think the additional size is just more "fillers" that are not needed as the drugs should be chemically identical.
Kincaid - disgusted Republican Partisan since 2006.
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rontuner
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Junior Carp
plays88keys
May 18 2007, 10:36 AM
George K
May 18 2007, 02:24 PM


(George - who asked the administrator of the OR. "When you come to have your surgery, which endotracheal tube do you want, the cheapest or the best?")



recognize this?


"What's a fair profit margin for a grocery store, a hardware store, or a piano tech?
How about Menards, Macy's or Costco?

5%? 8%? 10%?

I don't know, the carping about obscene profits seems to want to hold one industry to a different standard than others.

Correct me if I'm mistaken. "
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Kincaid
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HOLY CARP!!!
plays88keys
May 18 2007, 10:43 AM
Kincaid, I know you work in the insurance industry and I like you, but some of these decisions you guys make about how best to manage another person's health just plain stink.

Fortunately I am not in the health insurance side. However, I've made my share of enemies trying to fairly determine legal liability and reasonable compensation for accident claims.
Kincaid - disgusted Republican Partisan since 2006.
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plays88keys
Pisa-Carp
Kincaid, it's that big yellow elongated thing with 682 on it. Trust me, it is *not* the same as Wellbutrin.
You can never get enough of what you don't need to make you happy.
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plays88keys
Pisa-Carp
rontuner
May 18 2007, 02:47 PM
plays88keys
May 18 2007, 10:36 AM
George K
May 18 2007, 02:24 PM


(George - who asked the administrator of the OR. "When you come to have your surgery, which endotracheal tube do you want, the cheapest or the best?")



recognize this?


"What's a fair profit margin for a grocery store, a hardware store, or a piano tech?
How about Menards, Macy's or Costco?

5%? 8%? 10%?

I don't know, the carping about obscene profits seems to want to hold one industry to a different standard than others.

Correct me if I'm mistaken. "

:confused: :confused: :confused:
You can never get enough of what you don't need to make you happy.
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George K
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Finally
rontuner
May 18 2007, 01:47 PM
"What's a fair profit margin for a grocery store, a hardware store, or a piano tech?
How about Menards, Macy's or Costco?

5%? 8%? 10%?

I don't know, the carping about obscene profits seems to want to hold one industry to a different standard than others.

Correct me if I'm mistaken. "


I'm not carping about obscene profits, Ron, you are. I am comparing quality of one product to another that is supposed to be "equivalent." I am willing to pay more for the better product, if it is better. What Plays said and I did as well, is that though they look the same, they are not the same. Ask anyone who's put an IV in if they can tell the difference between a good needle or a cheapo. Did you pay extra for a good tuning hammer? How come? I'll betcha it was because it's better.

By extension of your thinking, a Rolls should cost as little as a Chevy, and a Piano Tuner should make as much as the CEO of General Electric.

Strawman, Ron, strawman.
A guide to GKSR: Click

"Now look here, you Baltic gas passer... "
- Mik, 6/14/08


Nothing is as effective as homeopathy.

I'd rather listen to an hour of Abba than an hour of The Beatles.
- Klaus, 4/29/18
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JBryan
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I am the grey one
Quote:
 
:confused:  :confused:  :confused:


Just some more of ron "backstroking in the Koolaid" tuner's drive-by posting.
"Any man who would make an X rated movie should be forced to take his daughter to see it". - John Wayne


There is a line we cross when we go from "I will believe it when I see it" to "I will see it when I believe it".


Henry II: I marvel at you after all these years. Still like a democratic drawbridge: going down for everybody.

Eleanor: At my age there's not much traffic anymore.

From The Lion in Winter.
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Kincaid
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HOLY CARP!!!
Plays - were you on Wellbutrin XL 300mg - the round white pill? That is really strange to me that it is so much bigger. A little scary to wonder what is in there that makes it so much bigger when it should have the same chemicals in the same proportions as the brand name.

I wonder what kind of clinical trials they put these thru before they say they are equivalent?
Kincaid - disgusted Republican Partisan since 2006.
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JBryan
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I am the grey one
Maybe the one Plays was in.
"Any man who would make an X rated movie should be forced to take his daughter to see it". - John Wayne


There is a line we cross when we go from "I will believe it when I see it" to "I will see it when I believe it".


Henry II: I marvel at you after all these years. Still like a democratic drawbridge: going down for everybody.

Eleanor: At my age there's not much traffic anymore.

From The Lion in Winter.
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katie
Fulla-Carp
On the upside, be thankful you're not a smoker. This drug is also used for smoking cessation & you might be tempted going off it.

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plays88keys
Pisa-Carp
Kincaid
May 18 2007, 03:07 PM
Plays - were you on Wellbutrin XL 300mg - the round white pill? That is really strange to me that it is so much bigger. A little scary to wonder what is in there that makes it so much bigger when it should have the same chemicals in the same proportions as the brand name.

I wonder what kind of clinical trials they put these thru before they say they are equivalent?

Yes - the little round white pill. And, if I had to guess, I'd say very little trial time. I think they were in a rush to get something out on the market ASAP.

The brand *is* expensive. 90 days' supply runs close to $400. I'm in no position to justify why it costs so much, but it certainly is effective. To me, that makes it worth it compared to the other junk that costs less and may even compound the problem it was intended to cure.
You can never get enough of what you don't need to make you happy.
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RosemaryTwo
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HOLY CARP!!!
Plays --

I feel your frustration, how angry you must be.

I remember after having a c-section for my second child, being dismissed from the hospital and stopping by the pharmacy to get my painkillers. It being my second child, I knew that I wouldn't be leaving the house a whole lot over the next month, so I wanted to get my prescription filled while I could. For some reason (I forget why) the pharmacy could only give me drugs for a few days (some insurance issue). They told me to come back in a few days.

Never tell a post-partum woman (who can't walk or drive) with a c-section to be somewhere in a few days for insurance reasons. My husband had to restrain me.
"Perhaps the thing to do is just to let stupid run its course." Aqua
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plays88keys
Pisa-Carp
katie
May 18 2007, 03:12 PM
On the upside, be thankful you're not a smoker. This drug is also used for smoking cessation & you might be tempted going off it.

It obviously didn't work for my carrot cake addiciton! :lol:
You can never get enough of what you don't need to make you happy.
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plays88keys
Pisa-Carp
Rosemary, I do understand.

Last night when I was whining about all this to Improv, he suggested I show up at the doc's office with a shotgun, tell them I was out of meds but had plenty of ammo and see how quickly a week's worth materialized. (he was joking of course)
You can never get enough of what you don't need to make you happy.
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katie
Fulla-Carp
plays88keys
May 18 2007, 12:16 PM
katie
May 18 2007, 03:12 PM
On the upside, be thankful you're not a smoker.  This drug is also used for smoking cessation & you might be tempted going off it.

It obviously didn't work for my carrot cake addiciton! :lol:

:hug:
Not to advocate a dose of porn, or seem unempathetic here, but maybe an extra little fix may help ya short term like ...

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Jolly
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Geaux Tigers!
George K
May 18 2007, 12:24 PM
What the HELL is wrong with you???

If it's cheaper, it's better! Get that through your head! We know what's best, and you have no business complaining. It is, after all, all about saving money for you, right?

(George - who asked the administrator of the OR. "When you come to have your surgery, which endotracheal tube do you want, the cheapest or the best?")

Another similar story happened with Mrs. George and her thyroid. She's been on "Synthroid" for 20 years. All of a sudden, she's sleeping all the time, gets bloodwork - thyroid level unmeasurable. Guess what, they changed to generics.

Bastards.

Hold on to you azz, fred, 'cuz you ain't seen nuthin yet!

The boys at the top are going through Pfizer right now, and it looks like slaughter of the innocents. From scientists down to detail guys, they whack 'em and stack 'em.

But I don't know if they have any other choice. Lipitor will be going generic, Viagra is going generic, Aricept is going generic (all within the next couple of years). There are no more billion dollar drugs in the Pfizer pipeline that I know about.

So where does that leave one of the world's largest, if not THE largest drug company?

Butting heads with every generic manufacturer in the world, as we race to the bottom to see who can hire a Mexican or Chinese plant to make supposedly equivalent drugs cheaper. Which is where most of Big Pharma is headed.

And as Medicare becomes the 800 pound gorilla in the drug market, just as it has in the hospital, it will drag the insurance companies along with it. Prescribe as written? Horse hockey, my son.

Have we got a deal for you.....
The main obstacle to a stable and just world order is the United States.- George Soros
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Daniel\
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Fulla-Carp
Quick story, when they gave me pain medication for my (now gone) skin rash, I called the doctor and told him I had taken all of the pills in half of the time I was supposed to (they were .5 milligrams and it wasn't working). He said if I agree to stay at .5 he will agree. I took the deal. I was scratching myself bloody. I was bad shape. I go to the pharmacy and they say: they called it in as a refill and we cannot refill it for two weeks.

Long story short they gave me my pills.

Best wishes- I am glad you got what you needed. :hug:



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