![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
osodecanelaRemember the movie "Network"? Peter Finch As Howard Beale screaming the line above. Well I'm just about there. Forgive me for the rant that's about to begin.
As a medical person I have a reasonable amount of expertise about health care and how it's distributed, and as some of you have noted in a post earlier this week insurance companies are not my favorite creatures. In our current system, I consider them a necessary evil. My own totally pissed me off today.
I have psoriatic arthritis. For those of you who are unfamiliar, psoriatic arthritis is the arthritis that affects some people (roughly 1 in 20) who have psoriasis. It does not correlate with the degree of the skin diseases -- my own skin diseases relatively minor -- and it has a predilection for small joints. Hands and feet are often the most affected, although the disease can strike anywhere. I was diagnosed in the early 90s and have been pretty well in remission for a long period of time. The early 90s was another story however. I stopped playing guitar, I was on multiple medications including oral gold and was ultimately put into remission by a then new drug, Celebrex.
I was treated with a "laundry list" of other anti-inflammatories at the time; Indocin, Lodine, Voltaren and Relafen, all of which were ineffective. Naprosyn, as well as the "profens" (ibuprofen, flurbiprofen, ketoprofen) were wonderful for treating the inflammation. Unfortunately, all four of them may be dropped my platelet count; thrombocytopenia is not a good thing. Celebrex was an absolute godsend. It worked both to relieve the pain and inflammation, it got me off of oral gold which is nephrotoxic, and actually put me in remission.
The last month has not been fun. Three weeks ago it became clear to me I was having another flare. Two fingers on my left hand plus another on my right and my right wrist are painful, particularly when I wake up in the morning. I've tried to get medication samples from the Celebrex representative that calls for my office, only to find we no longer have a rep that calls on our office. So, I called my provider to get a prescription only to have my insurance company reject it. Not covered, at least not covered unless I go through a whole slew of other drugs first. I called my provider again today to see if he has samples and to see if I can get him to process a prior authorization with my insurance company.
Bottom line, after he writes a letter detailing all the things that happened to me with my rheumatologist (who has incidentally retired), they should issue an authorization. A good thing? I think not. My co-pay for a month's supply will be $50. I can send the prescription to Canada and pay $51 (plus shipping) for the branded product, or get a generic which is available in Canada though not here for $14 less than my co-pay. Even if I choose to buy the medication here, paying my $50 co-pay, the pharmacy will only collect another $11 from my insurance company.
So much for American healthcare and our wonderful insurance companies who are micromanaging my arthritis. And for tonight I will sit here and channel my inner "Howard Beale".
As a medical person I have a reasonable amount of expertise about health care and how it's distributed, and as some of you have noted in a post earlier this week insurance companies are not my favorite creatures. In our current system, I consider them a necessary evil. My own totally pissed me off today.
I have psoriatic arthritis. For those of you who are unfamiliar, psoriatic arthritis is the arthritis that affects some people (roughly 1 in 20) who have psoriasis. It does not correlate with the degree of the skin diseases -- my own skin diseases relatively minor -- and it has a predilection for small joints. Hands and feet are often the most affected, although the disease can strike anywhere. I was diagnosed in the early 90s and have been pretty well in remission for a long period of time. The early 90s was another story however. I stopped playing guitar, I was on multiple medications including oral gold and was ultimately put into remission by a then new drug, Celebrex.
I was treated with a "laundry list" of other anti-inflammatories at the time; Indocin, Lodine, Voltaren and Relafen, all of which were ineffective. Naprosyn, as well as the "profens" (ibuprofen, flurbiprofen, ketoprofen) were wonderful for treating the inflammation. Unfortunately, all four of them may be dropped my platelet count; thrombocytopenia is not a good thing. Celebrex was an absolute godsend. It worked both to relieve the pain and inflammation, it got me off of oral gold which is nephrotoxic, and actually put me in remission.
The last month has not been fun. Three weeks ago it became clear to me I was having another flare. Two fingers on my left hand plus another on my right and my right wrist are painful, particularly when I wake up in the morning. I've tried to get medication samples from the Celebrex representative that calls for my office, only to find we no longer have a rep that calls on our office. So, I called my provider to get a prescription only to have my insurance company reject it. Not covered, at least not covered unless I go through a whole slew of other drugs first. I called my provider again today to see if he has samples and to see if I can get him to process a prior authorization with my insurance company.
Bottom line, after he writes a letter detailing all the things that happened to me with my rheumatologist (who has incidentally retired), they should issue an authorization. A good thing? I think not. My co-pay for a month's supply will be $50. I can send the prescription to Canada and pay $51 (plus shipping) for the branded product, or get a generic which is available in Canada though not here for $14 less than my co-pay. Even if I choose to buy the medication here, paying my $50 co-pay, the pharmacy will only collect another $11 from my insurance company.
So much for American healthcare and our wonderful insurance companies who are micromanaging my arthritis. And for tonight I will sit here and channel my inner "Howard Beale".
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
no subject
Date: 2008-03-12 06:29 am (UTC)I know it has complications, but maybe for a temporary thing...
(Yes, this is BD acting like a doctor, with a doctor)
no subject
Date: 2008-03-12 03:21 pm (UTC)My mother had rheumatoid arthritis, so I'm very familiar with the "NSAID roulette" and how individual reactions to these drugs can be. For me, ketoprofen is extremely effective, and ibuprofen might as well be PEZ. Guess which one I can't get over the counter anymore? Hence the fact I've gone back to good old cheap aspirin....