Blog | Tuesday, November 26, 2013

Being a good doctor by working around prescription costs


This article should frustrate everyone, The Soaring Cost of a Simple Breath

Every day that I make rounds, we have discussions about prescription drug costs with the students and residents. We are all learning to become adept at finding low cost alternatives to high drug costs.

This particular article describes a most troubling problem, the ridiculous cost of asthma inhalers. I do mean the adjective ridiculous. This pricing is obscene. It leads to patients not being able to afford to treat their disease.

In the adult inpatient service we mostly see COPD patients. I almost never prescribe inhalers. Inhalers work well, but for price reasons we use nebulizer machines instead. Nebulizer machines are much less expensive than a single inhaler, and then we can prescribe generic asthma medication solutions to use with the nebulizer. They are inexpensive through Wal-Mart, Walgreens and other pharmacies. Often we can get patients a free nebulizer in our hospital, and then the costs become reasonable.

For hypertension, we have become adept at using generic drugs. We try the same for diabetes, left sided heart failure and even lipid medications.

We have a responsibility to our patients to weigh the costs of their medications. We should learn the unreasonable costs of prescription meds and work around those costs.

The pharmaceutical manufactures will lower their prices if they see that high prices lead to fewer profits. We physicians must lead the charge to think of the patient’s finances first!

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Associate Dean for the Huntsville Regional Medical Campus of UASOM. He also serves as a frequent ward attending at the Birmingham VA Hospital. This post originally appeared at his blog, db's Medical Rants.