Monday, November 9, 2009

Pretty Colors

Mrs. Freek, I'm so glad Cymbalta at 60mg each day has helped your symptoms.

I'm sorry I don't seem very sympathetic in refusing to write a letter to your insurance company about the drug. Honestly, this stuff ain't cheap, and you should appreciate that your company is willing to cover it for you at all.

The 30mg and 60mg pills cost about the same per pill. So taking two of the 30mg each night, instead of one 60mg, basically doubles the price. And I really don't have a good reason to tell your insurance that they should pay the higher cost.

There might be medical reasons SOME people need this, but "because I like the cute blue & white 30mg, and not the ugly blue & green 60mg" is not one of them.

I also appreciate that blue & white are the colors of your alma mater, but again, I don't think your insurance company is going to feel that justifies them paying twice as much for your pills.

And for once I agree with them.
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26 comments:

  1. The Monflyg ManNovember 9, 2009 at 4:04 PM

    You might suggest to her that a bottle of Liquid Paper only costs a couple of bucks.

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  2. KarenNovember 9, 2009 at 4:13 PM

    Wow - next time I get a prescription refill, I'm going to demand that the doctor see if my meds come in colors I like too! Thanks, Dr. Grumpy, for such an inspirational post!!!

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  3. DaniNovember 9, 2009 at 4:25 PM

    Haha, and we wonder why things cost so much. Idiots like her don't help it. :(

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  4. AnonymousNovember 9, 2009 at 4:56 PM

    And this is why health care reform is doomed in this country.

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  5. MTSNovember 9, 2009 at 5:00 PM

    well, the purple one IS the one seen constantly on TV - maybe the overexposure increased her aversion to its color :-)

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  6. FrankNovember 9, 2009 at 5:13 PM

    I used to have patients refuse meds (back when I worked retail) because the generic wasn't the same color it used to be. They would absolutely refuse to take a little blue pill, because they were convinced that blue was a much less effective color than white.

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  7. J-Quell'nNovember 9, 2009 at 7:30 PM

    I'm slightly confused (perhaps I need a consult, Grumps?)...you are a neurologist...I get it...you deal with the brain and nerves...isn't Cymbalta an antidepressant? I mean...I guess I get it, but it still confuses me...don't you deal more with the physical aspects of the brain, or am I not fully understanding neurology? If you guys deal with the other aspects of the brain, why do we need Psychiatrists?

    I know, I know...I'm an idiot...but humor me? Please?

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  8. Grumpy, M.D.November 9, 2009 at 7:34 PM

    Cymbalta is also used for diabetic nerve pain, and other chronic pain syndromes.

    And all neurologists, whether we like it or not, end up doing some psychiatry. Patients with neurological disease are often depressed or anxious, and realistically very few psychiatrists take insurance anymore. So somebody has to treat them.

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  9. Bored MumNovember 9, 2009 at 8:46 PM

    In choosing the colours of your meds, does that make them designer drugs?

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  10. UnknownNovember 9, 2009 at 9:10 PM

    Dr. Grumpy, why are you being so rigid in your decision? I mean, honestly, you could prescribe some of the 30mg pills for special occasions. It's the least you could do.

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  11. AnonymousNovember 9, 2009 at 9:58 PM

    Give her Savella - those come in
    blue...

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  12. JimAtTheRezNovember 9, 2009 at 10:18 PM

    Wow, and just when you think you've heard it all, lol.

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  13. ChrisNovember 10, 2009 at 1:19 AM

    Ya got any crimson and gold for us USC fans?

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  14. ausduckNovember 10, 2009 at 2:15 AM

    I have an idea - "colour your own" packs from the drug companies! I can see it now, little groups getting together for little "pill painting parties". May take over from quilting and scrapbooking!

    Of course, there would be the problem with drug identification if all pills were white, but hey, what's a little safety & inconvenience to your Dr or Nurse when you could have your presription meds match your outfit, your cat's outfit, the car, the curtains, your alma mater... the possibilities are endless :)

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  15. AnonymousNovember 10, 2009 at 7:39 AM

    Do you have ANY patients that aren't certifiable or idiots??? You have th patience of Job, Dr. G.

    Kudos for keeping a straight face and your OWN sanity.

    Pattie, RN

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  16. J-Quell'nNovember 10, 2009 at 7:40 AM

    Ah...it all makes so much sense...I didn't even think of diabetic neuropathy...and the insurance thing...totally get it...even understand the pain/depression thing...just surprised me a little. Thanks for explaining, Grumps :)

    Now, could you do something to get my Zoloft in plaid or with polka dots? :D

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  17. Grumpy, M.D.November 10, 2009 at 7:41 AM

    Pattie- Of course I do. And they account for most of any medical practice.

    The problem is nobody wants to read about normal people, so they don't make the blog.

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  18. pharmboyrxNovember 10, 2009 at 10:09 AM

    I wonder how much I could charge to swap capsule colors for people who have specific tastes. Don't like your blue capsule? I can switch that out for pink for a $20/30 capsules fee!!

    I think I'll stick to flavoring childrens' medication.

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  19. ERPNovember 10, 2009 at 11:15 AM

    This discussion just justified the use of this drug in the first place. (although not the 30mg pill x 2)

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  20. xtineNovember 10, 2009 at 4:59 PM

    Honestly?

    I'd expect nothing less from a carolina grad.

    The sad part? She's still leagues ahead of most of UNC's fans: she actually went to the damn school.

    ;) GO PACK! And then the dookies.

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  21. LipstickNovember 10, 2009 at 10:43 PM

    I love it Dr. Grumpy...I'm pretty sure she asked the pharmacy if they could change the color of those caps too.

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  22. AnonymousNovember 11, 2009 at 10:42 AM

    I'm with PWin .. you could compromise with her and prescribe the blue and white ones for Homecoming. Dang, Dr. Grumpy ... get with it!

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  23. AnonymousNovember 11, 2009 at 5:43 PM

    What is missing is the answer to the question of why the 30mg and 60mg pills cost about the same.

    Certainly suggest that drug company prices have little to do with production cost.

    My Doctor prescribed the max dose of a certain little blue pill (again about the same price per pill no matter the dose) while suggestign that 1/2 or even 1/4 would probably work fine.

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  24. Frantic PharmacistNovember 11, 2009 at 5:47 PM

    Better get hold of that Prior Authorization Form for Color Preference and General Appearance.
    I think it's in triplicate.

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  25. AnonymousNovember 11, 2009 at 10:57 PM

    One of my first jobs as an intern at Osco Drugs was to dump out a brown stock bottle of Lilly's Prozac, and picking all the capsules that had Lilly written on them as they were mixed in with those that were imprinted with Lilly's generic company brand imprinted. The patient supposedly felt a lot better taking the ones marked Lilly than the other made on the same lab bench, so to speak, may've been more closer to the window there and thus a more 'sunshiny' dose. Perhaps, Sarafem made Lilly a lot more money as Sarafem than generic Prozac, or at least 'some' money as a brand-name drug, since generic fluoxetine is on Wal-mart's 4$ list.

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  26. DragonflyNovember 15, 2009 at 7:30 AM

    What about the pink sparkly ones? The true "party pills".

    ReplyDelete

So wadda you think?