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Post by Admin on Apr 16, 2019 19:47:40 GMT -4
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Post by Brayden Irving on Apr 16, 2019 20:29:28 GMT -4
I think that the article brings up a good point. The sad part it, that this isn’t just for cancer drugs. Patients seem to have issues consistently with getting prescriptions filled properly, and from my experience so far there is only so much the physician or their office can do to help things along. The fact that some offices need to hire a specific person to help sort through this seems like a waste of time and resources, when insurance claims should mostly be straightforward. The author and some of the doctors in the article raise a good point, there should be some sort of system to keep PBM’s and insurance companies, or get some universal healthcare system in place.
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Post by Manish Kanukunta on Apr 16, 2019 20:43:03 GMT -4
I found this article pretty interesting, because I did not realize how complicated it can be for patients to receive life saving medications. The article talks about PBMs and how they make it difficult for patients to receive the proper medication in the right amount of time. From what I read and understand, it seems to me that BPMs are creating an issue that needs to be addressed by policy makers. I do not think its fair for patients, doctors, nurses, and medical staff to jump through hoops just to get a medication authorized and approved. On the other side, the article mentions groups such as the COA who are against the PBMs, use pharmaceutical companies as corporate members. Two doctors mentioned in the article, Divers and Oubre, have received money from drug companies. This could also be seen as a bribe in order for pharmaceutical companies to influence physicians to fight against PBMs. Overall I do believe that PBMs do pose a problem when it comes to acquiring expensive medications for life threatening medical conditions. I also question groups such as COA, because of the money received from corporate sponsors. As a result, this conflict between insurance companies, physicians, and PBMs do not benefit the patients who need the medication.
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Post by Varoon Kakaiya on Apr 16, 2019 22:18:22 GMT -4
I think this is boiling down to two main things that need to be fixed: 1) Wait times and hurdles for patients to get needed medication are too big and 2) Cost of medicine is prohibitive. Like Brayden said the entire system seems to be entirely too disorganized and is more than likely due to various lobbying over the years. Cost of medicine is ever increasing. There was a recent inquiry by the Senate Finance Committee inquiring PBM executives as to why drug prices are so high. I think no consensus was really made and there was "a promise of more transparency in the future." Honestly, I think the only way I could see this being resolved is through some government intervention in the future. The ones who are suffering most right now are the patients.
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Post by Katherine Mitry on Apr 16, 2019 22:36:16 GMT -4
The fact that pharmaceutical companies, insurance companies, and PBMs play such a large role in the treatment patients receive in unfortunate. Doctors go through years of training to be able to take care of their patients and offer the best treatments available with the well being of their patients in mind, only to be subtly controlled by these businesses, which are primarily out to make money. This affects the quality of care patients receive, especially those that need more expensive drugs, such as cancer patients. In addition, the fact that there are no real consequences for the delays in sending these patients their medications seems to be a major part of the problem.
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Jannette Rios Rivera
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Post by Jannette Rios Rivera on Apr 16, 2019 22:50:25 GMT -4
I was really surprised about this article. I have heard from physicians that getting the correct medication for a patient can be complicated, and have to go for a cheaper version so the insurance can cover it, but was not expecting to this extent. If a patient is in an life or death situation, there should not be an excuse for not to give the patient the appropiate treatment. This corporations are making getting a medication that can save a life, difficult to obtain. They are even deciding what medication are more appropiate for a patient, when a doctor knows that a patient would benefit more from a certain medication. Also in the article it mentions that who is in control of the price of this medications are this companies, making then have a complete control of who should get the medication for their benefit. They are even making the patients suffer from complications from their diseases that could end in hospitalization or in death by delaying or denying the medications. I think is not fair that they are making this patients suffer more when their goal should be to help improve the health of the patients.
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Post by Marietta Young on Apr 17, 2019 8:07:56 GMT -4
As I was reading through this article, I found myself growing increasingly frustrated by all of the red tape that interferes with potentially life saving treatment. The medical field is already saturated with so many small tasks it is anxiety inducing even for a third year medical student. I worry about that day when I have to prescribe a less-than-ideal drug because it's the only one that insurance will cover, or the only one the patient can afford. When the article stated that nurse Bateman spent over 16 hours on the phone trying to get Lear her medication, I was absolutely baffled. In my albeit limited clinical experience, I have never seen a nurse/receptionist/provider with that amount of time to devote to a single issue. And, if it is this confusing for people in the medical field, I can't imagine how mind numbingly upsetting it is to a patient who is just trying to follow doctor's orders. I have to say that I personally agree with the COA's distain for step therapy. If we know one drug will work better than another, why can't we just start with that one? When patient care becomes a corporate affair, everyone suffers.
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Post by Carol Njoki on Apr 17, 2019 11:14:56 GMT -4
It seems from this story that the patient had a bad experience. If her story is an experience of many then speciality pharmacies should be evaluated. On the other hand I think the need of speciality pharmacies is undeniable crucial. They
provide optimal care to patients with complex, rare, or life-threatening illnesses. The do so by developing and maintaining relationships with their prescribing customers.They also promote awareness regarding newly approved products but also serve as an information resource regarding a medication.
Unless a prescribers participated on clinical trials of a drug, they have no experience in treating patients receiving these new drugs. Specialty pharmacies play a critical role in informing prescribers of appropriate dosing regimens, clinically relevant drug interactions, laboratory monitoring parameters, and required supportive care related to the new product.
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Post by Nawal Paul on Apr 17, 2019 16:04:58 GMT -4
Aside from doctors, pharmaceutical companies, insurance companies, and PBMs play important roles in the treatment patients receive. As such it is difficult to place blame on any one institution for a failure in the medicine chain. Insurance company’s forms are very lengthy and technical. If a patient made a mistake or misunderstood a point and gave wrong information, such a patient can incur costs and be delayed or exempted from receiving drugs. It is sad that a patient does not receive a medicine when he/she needs it the most. PBM or COA, insurance companies should not just focus on the financial part of life-saving drugs but also should consider how the delay in the provision of a drug can play role in life and death battles. I agree there should be some sort of straight system for life saving drugs or all drugs.
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