[golfing eagles]

Originally Posted by Mikeod

Not to mention how much time is wasted in the exam room discussing why the heavily advertised drug is not being prescribed. Everyone wants the one they saw on TV, not the one that has been used effectively and safely over the years. A new drug was not added to our formulary unless and until it demonstrated a definite and significant advantage in its class.

Exactly---hours and hours and hours talking to a brick wall because they "saw it on TV". Very hard to control this in an office setting. On the other hand , I was chairman of our hospital's pharmacy and therapeutics committee for many years, and the same criteria you just mentioned was employed. A lot easier to dictate drug choices to a captive audience , especially when you don't carry that drug.

[dillywho]

Originally Posted by golfing eagles

Exactly---hours and hours and hours talking to a brick wall because they "saw it on TV". Very hard to control this in an office setting. On the other hand , I was chairman of our hospital's pharmacy and therapeutics committee for many years, and the same criteria you just mentioned was employed. A lot easier to dictate drug choices to a captive audience , especially when you don't carry that drug.

[dillywho]

Originally Posted by golfing eagles

Even better because you know what you are talking about

I've never been a fan of direct to consumer drug marketing, ever since Merrill-Dow put out that 1st vaguely veiled trental commercial 30 years ago. It's confusing to patients, doesn't really enhance patient care, and in many cases you are right--I also consider it a waste of money. But the executives at the pharmaceutical company must disagree. Now, however, the ads are ridiculous, both in number and scope. After listening to their endless list of "side effects", I'll bet patient compliance with their prescription meds has taken a quantum drop. Heck, if I didn't know better I wouldn't take what I take either. I find it amazing that most of the ad focuses on the 2-3% "side effects" rather than the 98% effect that the drug was designed for. Coincidentally, I just returned from my pharmacy where my wife's meds cost over $400/month out of pocket
The colonoscopy story is ridiculous, I've never seen a denial for a procedure that had a 100% indication. I suspect the 1st representative was , well to put it politely, confused. I also think your husband shouldn't have had to be the one arguing, his doctor should, and frankly, we get better results. I'm really amazed at that denial, and that was from a privately employed worker at a private insurance company that has some vested interest in customer satisfaction--after all they have competition. A little scary to think what will happen when government bureaucrats run the whole show.

I think that whole outfit was, as you put it, "confused". Case in point:

I got a "survey" from them which was equally as ridiculous. They asked how much I drank on a weekly basis. Nothing about what I drank, when I drank, etc. Their response was that I "might need to talk with my doctor since it appears I may have an alcohol abuse problem." My doctor was the one in the first place who suggested I have a glass of wine in the evenings with dinner (we called it supper, but whatever).

Another question asked if I had had a hysterectomy, partial or total? I checked total. The response was that I "might need to talk with my doctor since I might benefit from hormone replacement therapy." Never asked if I had been prescribed HRT!

I returned said "survey" and told them not so politely, I'm afraid, what I thought of their survey and why. It was a total waste of my time, money, and their resources, which I also pointed out in my remarks.

Unfortunately, they had no competition in the area at that time. Our other choice was Cobra with no company participation for retirees. We could only take either for 10 years or to age 65, whichever occurred first.

If HMO's are designed to cut costs and increase efficiency and they are operated like that, then the design has failed miserably.