Monday, January 19, 2009

Wrong Number?

I don't know why, but I occasionally receive faxes that appear to be for a doctor's office. My office fax # goes to my email inbox and the wrong numbers are indistinguishable from the faxes meant for me until I open and read them.

When I first discovered this, I called the originating number. The office at the other end of the line had no interest in investigating the matter. Thereafter, whenever prescription requests and sensitive medical information for a variety of patients pop into my inbox, I delete them immediately.

But this fax that came today was too good not to share.
I have a mischievous desire to turn up at this free "educational" dinner. After all, it might have been for me. Technically, a PhD can call herself Dr. X. If it was meant for a potential patient, I am under the care of a rheumatologist.

This invite is too delicious. Don't you just feel a frisson of excitement to learn that the chef has a famous father? Celebrity! Free food and booze! Continuous learning credit!

BTW, I am not impressed by the lecturer's title. One of our friends is an associate professor at the same medical school. She says that the only thing she needed to do to become an assistant professor there was to say yes when they asked her to "volunteer" to teach one day a week at their teaching hospital. She knew that if she said no, then she might lose hospital admitting privileges.

Then the school was investigated for discrimination; one of the factors cited was the skewed ratio of male to female tenured faculty vs. the more even ratio for untenured faculty. Shortly thereafter, she received a letter informing her that she (and a whole bunch of women) had been granted tenure. She never even applied for it. We joked that it was the easiest tenure review ever.

Have you read Uwe Reinhardt's illuminating series about why US health care costs so much? As a heavy health care consumer, I have opinions. But his economic analysis looking at the big picture was eye-opening.

I am still grappling with whether I should start this drug, which costs over a thousand dollars a month for the hope that it might save my mobility.

"You want to walk, don't you?"

Speaking of fear tactics, one of the arguments being trotted out is that you don't want a government bureaucrat performing cost benefit analysis to limit your options under government sponsored insurance. In the US, we have people at insurance companies with no medical training determining "medical need". To provide evidence for the insurers, the vast majority of drug trials are funded solely by drug companies, which have the right to review and edit articles for research that they fund. The drug companies also fund the continuing education for the physicians.

I happened to come across a British National Health double blind study looking at several treatment options for my condition. It was way more balanced and thorough (double blind!) than the ones sponsored by the drug companies. It did not rule out the use of the expensive patented drugs.

If I had read that report earlier, I could have saved myself 6 months of puking up this other drug, which eroded the valve between my stomach and esophagus, which then led to me breathing HCl fumes, which then lead to asthma, which then lead to steroids for the asthma, and increasing strengths of heartburn medication, and one infection after another, which led to antibiotics, which led to thrush... I told my doctor that I wanted off the Rx merry-go-round before I developed C. difficile.

If I had read the British National Health study first, I would have read that it is highly unlikely that anyone can take a high enough dosage orally and keep it down. Thus, they resorted to infusions, which is why they were able to do a double blind test. And they found that the cheap generic drug worked as well as the thousand dollar a month drug, but they were both very dangerous drugs. I concluded that they both should be avoided until there was no other alternative.

On a positive note, I never did keep enough of that drug down for my hair to fall out. But I did start to go prematurely gray. If it hadn't been for that, my hair would be as dark as my older sister's. That's my story and I'm sticking to it.

6 comments:

  1. "one of the arguments being trotted out is that you don't want a government bureaucrat performing cost benefit analysis to limit your options under government sponsored insurance."

    I'd rather the government worked out which drugs should be paid for than an insurance company. The government is informed by a committee of experts, and the whole system (despite occasional cries of woe from the media about people who have to wait ages in emergency departments - usually because they are there for things they should have seen a GP for) works really well.

    And in any case, in Australia, we can still get medications that aren't approved by the PBS, they just aren't as cheap.

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  2. By the way, the link to the first drug doesn't work - is it this? If so, here it would only cost you $32.90 because the government pays $1828.57.

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  3. Yes, that is the drug. Gee, I wonder why it is so much cheaper in Australia?

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  4. Ugh, don't get me started on the fishiness of drug trials sponsored by the drug companies. I feel funny about being pushed a certain drug, then noticing the doctor using a pen with that drug name emblazoned on it, then wondering what else that drug company is paying the doctor for... The argument is that pharmaceutical industry should be a free market enterprise with potentially huge profit margins in order to spur new developments and treatments. But there's a huge conflict of interest there and I don't know what the best solution would be.

    And drugs are so much cheaper outside the US (i.e. Sicko and the 5 cent inhaler in Cuba) because the laws on patents/etc don't extend overseas I think... And without the potential for big profits achievable in the US market, drug companies wouldn't devote the necessary resources to develop new therapies.

    Ack! The whole thing is terribly upsetting to me. I guess the crux of it is this: is medical care a unalienable human right or a privilege? Where does the line get drawn (i.e. bare survival or improvement in quality of life or???)?

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  5. My recent hip x-ray was almost normal. The spacing appears to have improved. I think it was the exercises the physical therapist taught me.

    Anyway, the rheumatologist says to stay with that PT and there is no need to even think about the dangerous drugs for now.

    Good news for cheaper, safer therapies and the national health care budget.

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  6. Good, I'm so glad, Grace, that you're getting better!

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