Apr

In steps the pharmacist

Posted by The *Angriest* Pharmacist as Drug Companies, True Story

Okay, I’m not an MD….not even close. Occasionally, I feel that I do have the knowledge (albeit basic) to suggest some therapeutic substitutions to a doctor, however. Today, I had to listen to a poor (monetarily), 85-year old man tell me how much his medicines cost him each month. I felt bad for him. He had never even filled at my pharmacy. He merely wanted some prices to save a few dollars. He had Part-D, but was in his donut hole. He couldn’t meet the out of pocket expense. It was drugs or food in his mind. I reviewed his drugs and jotted the following note:

Eplerenone —> Spironolactone (he’s 85, he can deal with gynocomastia)

Tiotropium —> Ipratropium (Tio breaks the BBB anyway)

Xopenex —> ProAir HFA (Is that inactive isomer really that freaking dangerous?)

Flomax —> Doxazosin (Seriously…come on…)

Toprol XL —> Metoprolol (BID dosing though)

Revatio —> Warfarin, Diuretics, Beta Blockers, ACE-I, Digoxin, O2 Therapy (these aren’t going to decrease M/M, but they will help with QOL. He was already on some of them…of course) - I couldn’t even fathom this one. The SE’s alone would kind of suck…I thought it was just used for PAH in women. BTW, it’s 900 bucks a month. Way to go Pfizer….eat it.

If the above changes were made/considered, it could potentially save this person THOUSANDS of dollars a year…and TONS each month. The substitutions are not lesser therapies. They are equivalent. They are generic. They are cheaper.

[email_link]
Or Print it...