[defrey12]

Originally Posted by SHIBUMI

The doctor is prescribing the drug..........he or she needs to do their due diligence to recommend the drug and then inform the patient of costs and side effects. If I wanted to diagnose myself I would then be the fool. Doctors have a responsibility to the patient. They are not just guinea pigs.

As "GE" said, stick to golf. ⛳️

[Johnsocat]

Im sorry, but I disagree. Drs.
Have access to ypu records and every one of them requires you list your current meds and allergies on your intake form, so they can be aware of any contraindications on any drug they prescribe. There is also a desk reference made for doctors called the "Physician's Desk Reference " (PDR) that is published so they can look up any drug, it's generic name as well and who makes it. Also listed are side effects.
Any good doctor will tell the patient what common side effects to look out for when they prescribe. And they will check to ensure it does not interfere with their current meds before they do so.

Originally Posted by OrangeBlossomBaby

This topic is about prescription medicine and costs. The doctors don't mention the costs, because the doctors aren't in business to sell you medicine. Doctors don't sell prescription drugs. That's not their job. Pharmacies sell prescription drugs. That's their job.

Just like if I need a wig because of chemo, my doctor won't know the price of wigs. My doctor doesn't sell wigs. The wig store sells wigs.

Or if I buy a golf cart and the golf cart store says I can get a nice wrap on the body with butterflies and my name on the front, and recommends a custom wrap shop that can make and install one for me. The golf cart salesperson doesn't tell me how much the wrap shop will charge me for the wrap. The golf cart salesperson doesn't sell wraps, so knowing the price isn't his job. If I want to know the cost for the wrap, I get in touch with the wrap shop.

The doctor isn't a pharmacist. The doctor hasn't memorized every possible side effect of every prescription drug, just so that some day, if he meets you and prescribes something for you, he can tell you what side effects your prescription might cause you. Every prescription comes with "patient information." Every pharmacist is trained in helping you to understand your medications, and how they act, and interact with any other medication you might be taking. That is THEIR job.

It has nothing to do with overcharging medicare. It has everything to do with staying in your lane.

[westernrider75]

Originally Posted by SHIBUMI

When a doctor prescribes a medication, how come they are not required to tell you what it costs and what the side effects are?

This seems to me to be the ethical thing to do. The patient should not have to ask for this info, many just accept it.

Doctors don’t necessarily know anything about your drug insurance and what the costs would be to you. There are tiers, deductibles, etc that play into the costs. They also are not always aware if a generic is available which would affect your costs. However, they should make you aware of any potential side effects or interactions with other medications that they prescribe.

[dtennent]

I have taken the same prescription to several pharmacies with my insurance info and got wildly different costs. There is no way a doctor would have all of that price information at their disposal. Besides, with all of the hoops that doctors have to jump through for the insurance companies, do they really have time to cost compare every prescription that they write? Generic vs. brand name is a different matter.

[retiredguy123]

I think what may be missing from this discussion is that the doctor needs to have some knowledge about the drugs he/she is prescribing, including the side effects and the approximate cost. Sometimes, the drug may be too expensive for the patient to afford, in which case, there is no reason to even prescribe the drug. The pharmacist may have a more comprehensive knowledge about the drug, possible substitutes, drug interactions, and cost. Also, the doctor may not know that the patient could be using other drugs prescribed by other doctors, but the phamacist may have additional information about that. So, the doctor and the phamacist need to work as partners to ensure that the patient gets the proper treatment.

[golfing eagles]

Originally Posted by Johnsocat

Im sorry, but I disagree. Drs.
Have access to ypu records and every one of them requires you list your current meds and allergies on your intake form, so they can be aware of any contraindications on any drug they prescribe. There is also a desk reference made for doctors called the "Physician's Desk Reference " (PDR) that is published so they can look up any drug, it's generic name as well and who makes it. Also listed are side effects.
Any good doctor will tell the patient what common side effects to look out for when they prescribe. And they will check to ensure it does not interfere with their current meds before they do so.

Except........

In the real world, patients don't list all their medications on their "intake" forms or even update us when they've had a new drug prescribed by another doctor. As far as the PDR goes, it lists every "side effect" or should I say anything any participant in the phase 3 study or after market analysis, whether it has a causal relationship or not. Look up Tylenol and see if headache is listed as a side effect. Look up Prozac and see if depression is listed as a side effect. It's absolutely ridiculous. If 6% of patients in the control group complained of headache and <1% in the treatment group did, they still list headache as a side effect of Tylenol. About 30 years ago I I brought this up with the publishers of the PDR and advocated for only listing those "side effects" that occurred more often in the treatment group than placebo. What I found out is that the majority of decisions concerning how the PDR describes drugs are not made by physicians or pharmacists, but by lawyers. And that's what you get as a result.

[TVTVTV]

Originally Posted by defrey12

Yep...

If you price shop and get your prescriptions at several different pharmacies, is there a national database that ties all your prescriptions together so that each pharmacy is aware of potential interactions, or do I have to look it up myself? Is the patient prescription list shared so each pharmacy can see all?

[Driller703]

Originally Posted by SHIBUMI

When a doctor prescribes a medication, how come they are not required to tell you what it costs and what the side effects are?

This seems to me to be the ethical thing to do. The patient should not have to ask for this info, many just accept it.

That’s silly

[OrangeBlossomBaby]

Originally Posted by Johnsocat

Im sorry, but I disagree. Drs.
Have access to ypu records and every one of them requires you list your current meds and allergies on your intake form, so they can be aware of any contraindications on any drug they prescribe. There is also a desk reference made for doctors called the "Physician's Desk Reference " (PDR) that is published so they can look up any drug, it's generic name as well and who makes it. Also listed are side effects.
Any good doctor will tell the patient what common side effects to look out for when they prescribe. And they will check to ensure it does not interfere with their current meds before they do so.

Here's the PDR listing of side effects for one of them meds I take.

Severe

heart failure / Delayed / Incidence not known
cardiac arrest / Early / Incidence not known
arrhythmia exacerbation / Early / Incidence not known
atrial fibrillation / Early / Incidence not known
epiphyseal closure / Delayed / Incidence not known
craniosynostosis / Delayed / Incidence not known
increased intracranial pressure / Early / Incidence not known
seizures / Delayed / Incidence not known
angioedema / Rapid / Incidence not known
serum sickness / Delayed / Incidence not known
Moderate

infertility / Delayed / Incidence not known
thyrotoxicosis / Delayed / Incidence not known
hyperthyroidism / Delayed / Incidence not known
elevated hepatic enzymes / Delayed / Incidence not known
heat intolerance / Early / Incidence not known
dyspnea / Early / Incidence not known
peripheral edema / Delayed / Incidence not known
angina / Early / Incidence not known
palpitations / Early / Incidence not known
hypertension / Early / Incidence not known
sinus tachycardia / Rapid / Incidence not known
growth inhibition / Delayed / Incidence not known
pseudotumor cerebri / Delayed / Incidence not known
osteopenia / Delayed / Incidence not known
osteoporosis / Delayed / Incidence not known
wheezing / Rapid / Incidence not known
Mild

alopecia / Delayed / Incidence not known
flushing / Rapid / Incidence not known
hyperactivity / Early / Incidence not known
irritability / Delayed / Incidence not known
diarrhea / Early / Incidence not known
anxiety / Delayed / Incidence not known
appetite stimulation / Delayed / Incidence not known
weakness / Early / Incidence not known
headache / Early / Incidence not known
nausea / Early / Incidence not known
vomiting / Early / Incidence not known
fatigue / Early / Incidence not known
anorexia / Delayed / Incidence not known
menstrual irregularity / Delayed / Incidence not known
weight loss / Delayed / Incidence not known
emotional lability / Early / Incidence not known
abdominal pain / Early / Incidence not known
amenorrhea / Delayed / Incidence not known
fever / Early / Incidence not known
tremor / Early / Incidence not known
muscle cramps / Delayed / Incidence not known
insomnia / Early / Incidence not known
hyperhidrosis / Delayed / Incidence not known
pruritus / Rapid / Incidence not known
rash / Early / Incidence not known
urticaria / Rapid / Incidence not known
arthralgia / Delayed / Incidence not known

If my doctor tried to TELL me all of this, it'd freak me out. If he printed it out and gave it to me, I'd read the top 5 results and freak out.

Good thing he simply told me that the med is just synthetic thyroid to replace the hormone that no longer gets produced, since I had a thyroidectomy in 1990.

That's JUST the list of potential side effects, of a prescription product that's just a synthetic version of a hormone a healthy body produces naturally. I didn't even look at the contraindication (drug-drug) risks.

The drug interactions category for levothyroxine is insane. If it was printed out, it'd be around 8-10 pages long, starting with alendronate and ending with warfarin.

Everyone has access to the PDR. You have access to it too. In fact, if you were AT the Doctor's office, and he recommended a prescription, and you had to just wait to confirm that the prescription was sent to your pharmacy so you could pick it up - you could look up the drug on the PDR while you're still in the doctor's office and read the whole thing all by yourself.

However, the PDR doesn't list prices. Know why? Here's why: Because THE DOCTOR DOESN'T SELL PRESCRIPTION DRUGS. That is not his job. If you want the prices, you can run an online search. You can check with your health insurance. You can check with GoodRx or Optum or whatever other med discount programs are available. You can check your preferred pharmacy. Those are the places to find prices on prescription meds.

[SHIBUMI]

thanks for entering some sanity into the discussion

Originally Posted by retiredguy123

I think what may be missing from this discussion is that the doctor needs to have some knowledge about the drugs he/she is prescribing, including the side effects and the approximate cost. Sometimes, the drug may be too expensive for the patient to afford, in which case, there is no reason to even prescribe the drug. The pharmacist may have a more comprehensive knowledge about the drug, possible substitutes, drug interactions, and cost. Also, the doctor may not know that the patient could be using other drugs prescribed by other doctors, but the phamacist may have additional information about that. So, the doctor and the phamacist need to work as partners to ensure that the patient gets the proper treatment.

[BrianL99]

Originally Posted by BrianL99

Anyone who knows how prescription medicine works in most of the world, a good example being Canada, would know the answers to above questions.

In the USA, drug companies spend more than any other sector, for Lobbying in Washington, DC.

Financial Institutions, Lawyers & Drug companies, control the US Congress.

Originally Posted by defrey12

Okay, waayyy off topic.

Really? The original post wasn't about the "cost of prescription medicines"? A requirement to prescribe generics? Who gets benefits from prescribing medicines and does that influence prescriptions?

I think you need to read the original post again or educate yourself about how other countries handle prescription medicines.

[SHIBUMI]

the 1,000$ an hour, 250 for 15 minutes Doctor has not enough time to investigate the drug he is giving you?

He just picks one out of a hat.......and lets the 20$ an hour pharmacy attendee explain it to you. Something wrong with that picture.

Originally Posted by OrangeBlossomBaby

Here's the PDR listing of side effects for one of them meds I take.

Severe

heart failure / Delayed / Incidence not known
cardiac arrest / Early / Incidence not known
arrhythmia exacerbation / Early / Incidence not known
atrial fibrillation / Early / Incidence not known
epiphyseal closure / Delayed / Incidence not known
craniosynostosis / Delayed / Incidence not known
increased intracranial pressure / Early / Incidence not known
seizures / Delayed / Incidence not known
angioedema / Rapid / Incidence not known
serum sickness / Delayed / Incidence not known
Moderate

infertility / Delayed / Incidence not known
thyrotoxicosis / Delayed / Incidence not known
hyperthyroidism / Delayed / Incidence not known
elevated hepatic enzymes / Delayed / Incidence not known
heat intolerance / Early / Incidence not known
dyspnea / Early / Incidence not known
peripheral edema / Delayed / Incidence not known
angina / Early / Incidence not known
palpitations / Early / Incidence not known
hypertension / Early / Incidence not known
sinus tachycardia / Rapid / Incidence not known
growth inhibition / Delayed / Incidence not known
pseudotumor cerebri / Delayed / Incidence not known
osteopenia / Delayed / Incidence not known
osteoporosis / Delayed / Incidence not known
wheezing / Rapid / Incidence not known
Mild

alopecia / Delayed / Incidence not known
flushing / Rapid / Incidence not known
hyperactivity / Early / Incidence not known
irritability / Delayed / Incidence not known
diarrhea / Early / Incidence not known
anxiety / Delayed / Incidence not known
appetite stimulation / Delayed / Incidence not known
weakness / Early / Incidence not known
headache / Early / Incidence not known
nausea / Early / Incidence not known
vomiting / Early / Incidence not known
fatigue / Early / Incidence not known
anorexia / Delayed / Incidence not known
menstrual irregularity / Delayed / Incidence not known
weight loss / Delayed / Incidence not known
emotional lability / Early / Incidence not known
abdominal pain / Early / Incidence not known
amenorrhea / Delayed / Incidence not known
fever / Early / Incidence not known
tremor / Early / Incidence not known
muscle cramps / Delayed / Incidence not known
insomnia / Early / Incidence not known
hyperhidrosis / Delayed / Incidence not known
pruritus / Rapid / Incidence not known
rash / Early / Incidence not known
urticaria / Rapid / Incidence not known
arthralgia / Delayed / Incidence not known

If my doctor tried to TELL me all of this, it'd freak me out. If he printed it out and gave it to me, I'd read the top 5 results and freak out.

Good thing he simply told me that the med is just synthetic thyroid to replace the hormone that no longer gets produced, since I had a thyroidectomy in 1990.

That's JUST the list of potential side effects, of a prescription product that's just a synthetic version of a hormone a healthy body produces naturally. I didn't even look at the contraindication (drug-drug) risks.

The drug interactions category for levothyroxine is insane. If it was printed out, it'd be around 8-10 pages long, starting with alendronate and ending with warfarin.

Everyone has access to the PDR. You have access to it too. In fact, if you were AT the Doctor's office, and he recommended a prescription, and you had to just wait to confirm that the prescription was sent to your pharmacy so you could pick it up - you could look up the drug on the PDR while you're still in the doctor's office and read the whole thing all by yourself.

However, the PDR doesn't list prices. Know why? Here's why: Because THE DOCTOR DOESN'T SELL PRESCRIPTION DRUGS. That is not his job. If you want the prices, you can run an online search. You can check with your health insurance. You can check with GoodRx or Optum or whatever other med discount programs are available. You can check your preferred pharmacy. Those are the places to find prices on prescription meds.

[SHIBUMI]

You mentioned to your patients some possible side effects. BUT, you still probably knew if the drug was cheap or very expensive from experience.

And the insurance company determines the price of the drug. Thanks for the confirmation, the pharmacist said the same thing.

Thanks for the kudos on golf posts...........like I said, I don't stray unless it's from personal experience.

Happy Golfing!

Originally Posted by golfing eagles

Well, after over half a million patient encounters, I think I have the "expertise and experience" required and I'll stand by my previous post. There is no way for a physician to know what the cost of YOUR medication will be, and even less how much YOUR insurance will cover. That is YOUR responsibility. As far as "side effects" go, I would tell patients only the serious ones and ask them to call me if they were experiencing anything unusual. Everyone has seen drug ads with the list of dozens of "side effects"---from the trivial to the fatal with no indication of how often they occur. My favorite is for one that states, "PML (progressive multifocal leukoencephalopathy) has not been reported but is possible". What does that mean? Alien abduction or the sun prematurely going supernova is "possible" as well. Let's all worry about that when taking antihypertensive medication. Also, I can guarantee if I told 100 patients that the "side effect" of medication A was itchy teeth and urine that glows in the dark, at least 8 of them would complain of exactly those symptoms. As far as drug-drug side effects go, that is the pharmacist's responsibility. Patients frequently get multiple prescriptions from multiple specialists and don't tell all of them all of their medication. Only the pharmacists have (should have) the complete list.

But I do like your golf posts

[golfing eagles]

Originally Posted by SHIBUMI

You mentioned to your patients some possible side effects. BUT, you still probably knew if the drug was cheap or very expensive from experience.

Thanks for the kudos on golf posts...........like I said, I don't stray unless it's from personal experience.

Happy Golfing!

Sometimes. For example, generics tend to be cheap. I knew some drugs that would tend to be expensive, but no idea to what extent insurance would cover the cost. My job was to choose the best possible treatment for the patient to lead to the best possible outcome. I did not sell drugs, I was not an insurer, nor was I an accountant. If a patient came back and stated they could not afford a drug, we would work to find the next best alternative. But to know the bottom-line cost for all patients, all drugs, and all insurers would not be possible

[REO7990]

Originally Posted by village dreamer

i think your new plan, would be a new doctor.....

It’s the job of the PHARMACIST when he’s filling your medication to advise you of any drug interactions at which time HE/SHE would contact the dr. Office for another Rx.