How often have you had the experience where you have written a prescription for what you felt was the best medication to treat a patient’s condition and later found out that the patient never filled the prescription?
For me as an Ophthalmologist, this is very frustrating because I often write prescriptions to treat chronic vision-threatening conditions for example glaucoma or to treat severe eye infections, for example, corneal ulcers or herpes eye infections.
Some of the reasons that prescriptions are not filled are valid. Some medications are simply too expensive, that is a tragedy. Medication prices have sharply increased for many reasons. Old medications acquired by new companies without competition have resulted in price increases sometimes over ten times the current price without justification. Newer medications start out with super high prices ie. a Hepatitis C pill that started out at about $80,000 for a treatment course. Sometimes competition and or consumer resistance to the price brings the price down. I believe the $80,000 drug is now $20,000 but is that even a fair price.
Nonetheless, some patients just do not prioritize their health and spending money on medication as a priority. I have seen patients with the latest I-Phone or expensive handbags who will not buy an essential medication with even a $75 dollar co-pay. Even after explaining to the patient why this medication is essential to their health they still don’t get it. For some reason, these patients do not want to take any responsibility, pay any money to make them healthier or keep them healthy. I think that this is a societal problem. Many patients operate under this bizarre assumption that someone else, their health insurance company, is responsible for their health and that they bear none of the responsibility for their own well being. This misconception needs to be addressed and patients need to understand that most insurance companies are for-profit entities who are loyal to their shareholders and not policyholders. Patients need to understand that they are the biggest stakeholders in their own health. They are the ones who derive the most benefit from being healthy and suffer the most consequences when they are not.
With regard to necessary medications that are unaffordable, we as physicians need to be our patient’s advocates to ensure that patients are not deprived of necessary medication (not necessarily the most expensive medication) when they are ill.
Drug pricing needs to change and the cost/time involved to get a medication FDA needs to be streamlined. There needs to be a faster process for new generic drug manufacturers to enter the market when a single manufacturer is price gouging.
It is rapidly approaching the point where more healthcare dollars go to medication than to physicians. The physician is often the scapegoat for the ills of healthcare yet we represent only a small percentage of total healthcare costs.
It is important that we discuss both among ourselves and with our patients the importance to them of following our advice, filling our prescriptions and taking responsibility for their own well being.
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