A SAMPLING OF YOUR RESPONSES:
I do believe that a preferred drug list allows bureaucrats to modify a doctor's decision about the best medicines for treatment including the fact that a person should not have to choose a generic drug, just because the insurer doesn't pay for the brand name drug. A persons life is more important than this. Their doctor knows what medicines are best for them!
Betty Janice Dooley, Charleston
I have recently been in this situation. My doctor wanted me on a certain drug, but was forced to prescribe a different brand because the drug she chose was not on the preferred list. I feel the doctoring should be left up to the doctors.
Jacqui McCallister, Ridgeview
There shoul be a cap on profits the drug companies can make on their product.
Tim Shanks, St. Marys
While physicians should be well educated on price consideration of medications, they should be able to prescribe the most appropriate prescription drugs to treat the diagnosed medical condition of their patient without inappropriate bureaucratic intervention.
Thomas J. Stevens, Charleston
I think that doctors should make the decisions as to which medications are correct for the patient. The payer should provide doctors info on cost, then let the doctor decide. Serious price controls will likely lead to less innovation in thye pharmaceutical industry.
Ronnie Coleman, Cincinnati
Health care practitioners are working daily to improve healthcare in WV while our law makers tie our hands.
George Bryant, Rupert
Indeed, preferred drug lists preempt a physicians independent judgment in prescribing the exact drug that he or she feels best for his patient. If the drug is not on the preferred drug list, then the doctor is forced to prescribe something else - perhaps inferior in quality or adaptability to the particular patient - or go through a bureaucratic maize to get approval to prescribe what his medical education, training and experience tells him is best for his patient. A PDL that is supposed to be saving money can actually drive up health care costs when this situation develops. Often the PDL drug is not correct for the patient which means the patient has to come back to the doctor or emergency room for other treatment later.
Karen Linger, Rosedale
A doctor should be able to decide what is the best course of treatment for their patients. If their hands are tied by which prescriptions will be paid for how can they make the best decisions for their patients? They can't. If the best medicine is one not on the list the patient will have to fail on medications that are before they can be placed on the medication that the doctor thinks would be best for them to start with. This is a very dangerous policy because sometimes patients have illnesses that a fail first policy could permanently damage areas of their bodies, not to mention the increased cost of when these people are put in the hospital because they are not recovering but getting worse. I would much rather my doctor be able to tell me what line of treatment I need than the state of WV tell me that my doctor's decision has to be changed because the medication he wants to put me on isn't on a list of medications. You wouldn't want a lawyer operating on ! your appendix, so why would you want politicians and insurance administrators making medical decisions about your care?
Beth Anderson, Ivydale
Even though several drugs may cure a specific malady, different side effect profiles and contraindications may exist which nessecitate one drug being presribed over another. One's physician is the best person to make this desicion, not an impersonal list.
Betsie Dobbs, Charleston
Patients should not be forced to change a treatment regimen that is working well for them just because that medication did not make the list.
Lynn Monday, Cross Lanes
All medications should be equally available for doctors to prescribe so there is no incentive for choosing other than the best drug for each particular case.
Ellen Ward, Charleston
This is a wrong move for law makers and HMO's to allow an outside input from anyone presuring a doctor to prescribe medicine or treatment to a patient based on the price of the medication could be detrimental to the patients health and further-more cause more lawsuites and make more doctors bail out of West Virginia for higher prices for Malpractice Insurance, so this really is a double sided issue of whats morally wrong and right and who suffers most in the end patient or doctor.
Jeremy A. Brannon, Charleston
Drs need more freedom. The chemical breakdown and application in patients from brand name and generic can be very different
A Shako, Schoharie
As a physician, I get called frequently by pharmacies requesting that I switch my originally prescribed medication to one that is on the preferred formulary list. For the most part, there are reasonable substitutions, but it does make me feel that I am being second-guessed regarding my medical judgement. The sad thing is, if I stand my ground and refuse to change the medication, then the patient is the one that pays. Some state plans even require that I call and speak with a pharmacologist to explain my rationalle for prescribing one drug over another. Obviously, they favor the cheaper drug. How ironic, however, if a patient fails with the cheaper treatment, that the pharmacologist isn't liable, I am ! But, in argument for this type of program/screening, one has to admit that the insurance companies and the state only have so much money to pay for medication, and it is just plain common sense that if you have choices of 2 drugs that are essentially equivalent, that the less expensive medication should be prescribed. Health care is very expensive, and to blatantly prescribe a $150 antibiotic when a $45 antibiotic will do the same thing is foolish. Many of our WV Medicaid recipients for years have had NO formulary, have not had to pay for any office visits, or drugs, and both they and the physicians have been used to having the Gold Card pay for it all. If these folks would have to pay a small copay for each visit or prescription, they wouldn't bring their kids in every month for a snotty nose. That's why the state has tightened up with formularies, the well only has so much water in it before it goes dry. They need to remember, everything cost something, and somebody has to pay for it. People with private insurance often have the same mentality. Fortunately, it is a minority of patients that do this, but the big abusers should be on a short leash.
Dr. Pepper, Parkersburg, WV
I am a Physician Assistant and I beleive not only do they interfere but in more instances thean you can imagine they prevent quality care and in fact make the cost of medicine actually go up.
James E Lowe PA-C, Beckley
No, but it sure makes a difference in whether you have a $5 or $10 co-pay or have to pay the whole cost because your brand specific prescription isn't on the preferred list
Jackie, Elkview, WV
If the purpose of Medicaid is to make health care accessible to those who cannot afford insurance, but qualify for Medicaid coverage, one would think that individuals covered by Medicaid would receive the same level of care as other insured individuals. This is not the case with the preferred drug list (PDL). An example is insulin requiring diabetics have been shown to have better postprandial (after meal) blood sugar control with the use of Humalog Mix 75/25 Insulin. This is evidenced by better Hemoglobin A1c values. Medicaid does not offer this to patients. Some of the drugs that are not on the PDL can be obtained in certain instances when the prescriber can take the time to write a letter to Medicaid requesting that an exception be made for the patient (if adequate justification for the exception can be shown). With Medicaid reimbursement for care low, the PDL shifts the cost to the already burdened health care provider, and worst of all, provides a differ! ent level of health care for the Medicaid recipient. Besides aren't kick backs illegal? I think in many industries the current way of granting drug status on the PDL might be seen as a kick back.
Janet S. Bennett, MSN, CS-FNP, South Charleston
If a doctor prescribes a medication, the patient should be able to purchase that medication. There should not be a preferred drug list. These drug list benefit the Insurance Company and the Drupg Companies, not the patient.
Carol, Chesapeake
Doctors choose specific drugs for special reasons for each individual. I don't believe that one drug will work correctly for all people.
Jacqueline Wayson, Cabin Creek
My husband is a UMWA member and because of this sort of thing we have to pay more than our contract calls for!!!
Maria Lambert, Seth
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