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Little Pricey Pill (Nexium is a parable of what's wrong with health care.)
Forbes ^ | April 12, 2010 | David Whelan

Posted on 04/10/2010 5:53:07 PM PDT by SmokingJoe

Along with so many other things, keeping a lid on spending seems to have gotten lost in the health care overhaul. Individuals lose some incentive to save a couple of bucks by having fewer tax-free dollars in their health savings accounts. A panel to oversee Medicare disbursements based on the cost of clinical effectiveness of treatments--zapped, thanks to intense lobbying by drugmakers, doctors and every other medical interest group. That leaves medical providers and health plans, which have little motivation, unless the employers who buy insurance turn the screws.

They rarely do. But Edward Kaplan, a New York City health care consultant, last year came up with a simple way to save a pile of money for a Boston union representing supermarket workers: Its medical plan stopped covering Nexium, saving $133,000. The heartburn medicine is a $5 billion blockbuster for its manufacturer, AstraZeneca ( AZN - news - people ). At $2,000 for a year's supply, it was the union plan's second-most-prescribed pill, accounting for 5% of all drug costs. But its active molecule is almost identical to the one you get in cheap over-the-counter versions of Prilosec.

Prescription drug spending is maybe 10% of the total health pie--$234 billion in 2008--and rising at 3% a year. Still, "cutting Nexium saved a big chunk," Kaplan says.

The journey of a thousand cuts might begin with a little purple pill. It should have started years ago. Nexium launched in 2001, just as the patent for Prilosec, AstraZeneca's original heartburn remedy, was expiring. Intense marketing around Nexium coincided with price increases for Prilosec, pushing many patients to Nexium. Doctors, easy to woo with drug sales reps bearing samples and company-commissioned research reports, were happy to write scripts for the new drug--and oblivious of the economic implications.

(Excerpt) Read more at forbes.com ...


TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: forbes; healthcare; nexium
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To: Hardastarboard

Small differences in molecules make a big difference. Besides, even generics and the name brand can cause different reactions.


21 posted on 04/10/2010 6:40:26 PM PDT by rmlew (There is no such thing as a Blue Dog Democrat; just liberals who lie.)
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To: SmokingJoe

The generic Omeprazol has side effect for me. Nexium doesn’t. I am careful of my diet, but still get severe acid reflux brought on by arthritis meds. It is not always diet that causes severe acid reflux.

Not all generics work as well, they have different fillers. For some there is not difference, but then God didn’t create us as exact copies of each other. Synthroid (name brand) works well for me, no side effects, have to be tested twice a year. GENERIC form is a disaster of side effects because of the fillers and are not absorbed by my body as well, does not come in as many strengths as the name brand, requires testing 3-4 times a year. So in the long run the name brand is the cheaper product.

Wal-Mart advil works well, no side effects, Walgreen’s has side effects...different fillers.

Drugs need to fit the person taking them. If generics work, fine, but some times they don’t because of fillers.

Renting machines like sleep apena machines which are long term use items, is stupid and costly, simpler and cheaper to buy them. Yet renting them is what Medicare forces us to do.


22 posted on 04/10/2010 6:42:01 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: Hardastarboard

Check out the other drugs you are taking, ALL arthritis meds cause acid reflux along with other gastro-intestinal problems.


23 posted on 04/10/2010 6:46:27 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: Hardastarboard

Have you tried Omeprazole?


24 posted on 04/10/2010 6:51:52 PM PDT by dsc (Any attempt to move a government to the left is a crime against humanity.)
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To: antiRepublicrat

“a lot of people taking Nexium could instead simply change their diet instead to stop the acid reflux”

Thank you! Not saying it’s what everyone’s problem is but I got rid of heartburn eating smaller portions of food at meals.


25 posted on 04/10/2010 6:54:53 PM PDT by mikey_hates_everything
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To: SmokingJoe
ts medical plan stopped covering Nexium, saving $133,000. The heartburn medicine is a $5 billion blockbuster for its manufacturer, AstraZeneca ( AZN - news - people ). At $2,000 for a year's supply, it was the union plan's second-most-prescribed pill, accounting for 5% of all drug costs. But its active molecule is almost identical to the one you get in cheap over-the-counter versions of Prilosec.

And not eating high-carb foods after 5:00 pm ends heartburn entirely - for zero dollars. :)

26 posted on 04/10/2010 6:56:26 PM PDT by Mr. Jeeves ( "The right to offend is far more important than any right not to be offended." - Rowan Atkinson)
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To: MrNeutron1962
Two points about Nexium.

First, it is anecdotal but it is suspected that so many people are using OTCs for heartburn and reflex that they are not seeing their doctors about these symptoms and as a result esophageal cancer is on the rise. The fastest growing cancer in the U.S. at the present time. www.ecan.org

The other point - my DH was dx'ed with Stage IVb esophageal cancer in Dec 06. He was given but a short time to live. We found a doctor who agree to take him to the limits with treatment --- instead of opting for the palliative care the first doc's recommended --- and today, after 7 rounds of chemo, 30 radiation treatments, surgery to remove his esophagus and 2/3 of his stomach - he is N.E.D. Because he no longer has an esop he relies on Nexium - 40mg twice daily to keep his acids in check. He cannot lay flat for risk of aspiration and the Nexium helps. You DON'T want to experience the use of Nexium post surgery.

PLEASE ... if you have reflux or heartburn for more than two weeks, see your doctor, ask for an endoscopy! EC is dreadful because it is found at such a late stage. If you have a chance to find it early - via the endoscopy - you have a shot at overcoming this dreadful beast. Again, please, get an endoscopy!

27 posted on 04/10/2010 6:57:40 PM PDT by zeaal
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To: MrNeutron1962

Oh my God,I am so sorry.


28 posted on 04/10/2010 6:58:35 PM PDT by Mears
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To: hosepipe

I tried OTC and Prevacid.....did not work very well.

Been taking Nexium about 10 years 40Mg per day. If I drop back to 20Mg the reflux returns. I will keep buying the Nexium at any price...not really a choice for me. Is Nexium over-perscribed? Don’t know, though I did try the cheaper one’s first so for me its the right medication.


29 posted on 04/10/2010 7:02:36 PM PDT by Martels Hammer ( America not so Compliant)
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To: GailA

YEah, I was on prozac once and now I can’t tolerate the generic kind. My doctor said it seems to work fine on people who have never had the name brand, but there appears to be some difference. Trouble is, the insurance company just says, no there isn’t, and disallows it.


30 posted on 04/10/2010 7:02:52 PM PDT by ichabod1 (Can around 25-30% moonbat base really steal the country from us and hold it?)
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To: SmokingJoe

I’ve found that my doctor has no idea what the drugs he prescribes cost.


31 posted on 04/10/2010 7:07:58 PM PDT by SWAMPSNIPER (The Second Amendment, A Matter Of Fact, Not a Matter of Opinion)
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To: SWAMPSNIPER

About 50% of the information covered in this thread is factually inaccurate.

I can’t straighten you out because then you might sue me.

In my neck of the woods the country folk swear by apple cider vinegar.


32 posted on 04/10/2010 7:15:37 PM PDT by JusPasenThru (Why won't those knuckle-dragging tea-bagging right-wing bastards just negotiate with me?)
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To: ichabod1

You can appeal it is your right, you need to give your doctor written permission to represent you, and a clinical reason must be given...i.e. you have bad reaction to the generic because of the difference in the fillers. Make sure you keep a copy and send one to your congress critter too.

You will of course be required to pay the name brand co-pay. Took me months of jumping through hoops to get my Synthroid covered. Now this is not an expensive drug $22 per 30 pills. Generic is $11 per 30 pills, IF YOU are paying for it.

We have Medicare B and Tricare For Life, which is the ins. that pays for our Meds. We are retired Military and Syntrhoid is FLAGGED as needing prior approval. Takes patience and an lot of phone calls/letters to your congress critter, but in the end I won. I sited Endocrinologist saying the generic is not as good, etc. Do some web research to put in your letters.


33 posted on 04/10/2010 7:19:23 PM PDT by GailA (obamacare paid for by cuts & taxes on most vulnerable Veterans, retired Military, disabled & Seniors)
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To: zeaal

Everyone in my family has a hiatal hernia. (None of us are overweight.) I do have an extremely stressful high intensity job. I have had two surgeries to try and cure the reflux. (They wrap your stomach around the esophagus.) They told me before the surgeries that my esophagus cells were turning into stomach cells because of the acid. (A potentially precancerous condition.) Only Nexium has stopped the problem.


34 posted on 04/10/2010 7:19:36 PM PDT by marsh2
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To: JusPasenThru

Peppermint oil works great!


35 posted on 04/10/2010 7:21:13 PM PDT by SWAMPSNIPER (The Second Amendment, A Matter Of Fact, Not a Matter of Opinion)
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To: SmokingJoe

I had heartburn for years. Coffee, onions, white bread and anything spicy could cause a flareup which would last up to three days. I lived on Tums and Rolaids.

Then my ex-wife suggested I try Prilosec every other day. I did and the heartburn vanished. It was like a miracle.

That was six years ago. I buy the Great Value workalike from Wal*Mart, same thing, much cheaper.

It is a real pleasure to eat anything I want and not have to worry about heartburn.


36 posted on 04/10/2010 7:22:27 PM PDT by upchuck (Get the Moslem rookie out of the White House!)
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To: the_Watchman
I did use Nexium I was 100% symptom free.

I was on Nexium but after two trips to the gastroenterologist showed the problem was not resolving, I ended up an Kapidex. Next visit showed complete healing.

I seem to recall the gastroenterologist telling me that although Kapidex was the latest drug for GERD it was a bit cheaper than Nexium.

I shudder to think how much the Kapidex costs. I'm very willing to buy and try OTC if a generic will do the trick.

37 posted on 04/10/2010 7:28:05 PM PDT by behzinlea
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To: antiRepublicrat
Well, you are only using your own experience. That's never a good idea to extrapolate that for the rest of the world. For many people a change in diet wouldn’t help. There are other medical reasons that someone can have reflux or G.E.R.D.

Steroid use is known to cause reflux. People who take steroids for medical reasons often suffer from it. It can be an inherited condition. Infants can suffer from it. It can be extremely painful for them so much so that these babies rarely sleep.

The one thing the article pointed out is that Nexium also heals the esophogus. That is something that Prilosec can not do. Some people need a bit more than Prilosec. And for some tagamet, antacids and other weaker medications are not strong enough.

Anyone that suffers from chronic reflux should not self diagnose. You could have something more severe than just reflux such as cancer. Nexium is for people that have damage or for whom other medication and change of diet and lifestyle have not solved their problem. Someone born with a problem would fit into that category.

In my family it seems to be the oldest child in every family. Starting in infancy. On breast milk only. Go figure. No Taco Bell runs LOL!~

38 posted on 04/10/2010 7:39:00 PM PDT by conservativegranny
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To: JusPasenThru

Apple cider vinegar would cause reflux in most people. It is very acidic.


39 posted on 04/10/2010 7:40:53 PM PDT by conservativegranny
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To: JusPasenThru
apple cider vinegar

You are right. Magic Elixir! I kid you not.

40 posted on 04/10/2010 7:42:14 PM PDT by VideoDoctor
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