I received a letter from my insurance company stating that two of my medications are no longer listed on their formulary. Seeing as I already pay $15 over the copay for each of them I don't know what this is going to mean to my wallet, but whatever it is, I'll just have to pay it. They did helpfully offer me a "generic alternative" for each of them, though! How swell of them! See, a generic alternative is NOT the same as a generic equivalent. An alternative is not the same medicine as the brand, whereas an equivalent is the same medicine. For example, Zyrtec, an allergy medicine, has no generic equivalent. Not yet. Zyrtec is citirizine HCl, but generic drug makers cannot make cetirizine HCl until Pfizer's patent runs out. A generic alternative to Zyrtec would be loratidine, the generic equivalent of Claritin. With me so far? The only thing these two drugs - Zyrtec and loratadine - have in common is that they're both prescribed for allergies. They are NOT the same drug. Patients are being told to ask their doctors for generic alternatives because they are cheaper than the brand name meds that currently have no generic equivalents available, not because they've been proven to work as well for the patient.

I have no problem with generic equivalents. With very few exceptions (such as blood thinners and thyroid medications) they are exactly the same medicine as what's in the pricier brand names. If a generic is available, I'll happily switch to it. Unfortunately, two of the medications that I'm currently taking have no such equivalent, not yet. I'd tried the cheaper "alternative" medications for each of them for months before switching to the pricier brand, and I'd switched to the new medications because the old ones didn't work for me. One of them even gave me some nasty side effects that I don't suffer from with the newer medicine.

So now I get this letter telling me to ask my doctor to switch me to these two alternative medicines in order to save myself some money. Yes, they do define what a generic alternative is in a footnote, but I'm thinking quite a few people are going to see the words "no longer covered" and "generic" and they're going to call their docs right then and there.

What gets me about this is our insurance is REALLY FREAKING EXPENSIVE. Like, SERIOUSLY expensive. So why the letter? I'm sure I'm not the only one who got one. Why the corner cutting? And why now? Why were these drugs taken off the formulary now when I've been taking them both for over 7 years?

Could it be they're paying more out to lobbyists and politicians to try and cut off any changes to the existing health care system from which they are making bajillions of dollars, and they need every buck they can get to fight the switch to a universal health care program, or even a competitive co-op program? Call me a cynic, but the timing is pretty coincidental.

1 comment:

Rev Transit said...

Keep talking like that and we'll soon be getting the kind of health insurance they have in Canada or France. That'd be just so horrible, wouldn't it?