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Rising Medication Costs & Gluten in Medications

Posted Jan 27 2009 3:49pm

A new report from the Washington, DC-based Center for Studying Health System Change finds that one in seven Americans under the age of 65 went without a necessary prescription medication in 2007, largely because of skyrocketing drug costs.

Now, you're probably thinking that the report applies to people who are uninsured...at least that's what I thought when I first looked at the report. But the study actually found that even people with private health insurance provided by their employers went without much needed medications. In fact, one in 10 working Americans with employer-sponsored health insurance chose not to take a prescription drug in 2007, up from only 8.7 percent in 2003. Why? According to study researchers, the most common reasons were rising drug prices, the introduction of new and more expensive specialty medications to the market, and " skimpier drug coverage that shifts a greater share of costs onto patients."

How does this affect people with celiac disease and those on a gluten-free diet? It's simple and it actually hit me right in the pocketbook just a couple of months ago.

I had what I thought was really good health insurance provided by my employer. But one case of pneumonia later and I found out it wasn't all that fabulous. My doctor prescribed an antibiotic to me that she described as a "bull-dog" to knock out the infection. She had also recently prescribed the same drug to another celiac patient and had already verified with the company that the medication was in fact gluten-free. Yay! What a sense of relief!

I took the prescription to the pharmacy, provided them with my insurance card and waited 20 minutes for it to be filled. When they called my name, I was thrilled and couldn't wait to swallow the first pill and get on the road to feeling better. But as the pharmacist rang me up, my jaw dropped and I almost started crying. The total for one prescription was $187.36. I couldn't believe it. I politely asked the pharmacist if she had run it through my insurance since I always paid $15 for every prescription. She kindly said yes and informed me that the medication was a tier 2 drug (or something like that) and that my insurance would only cover a small percent unless my doctor could prove that I had to take this particular drug over a less expensive alternative like a generic.

So thus began a chase to track down my doctor, explain the situation and try to get the insurance company to cover the antibiotic. The first problem we ran into was finding a medication that we could verify was gluten-free. I'm allergic to penicillin and all of its relatives and my doctor was unsure about the inactive ingredients in a lower-cost generic antibiotic. She waited about 12 hours to hear back from the drug company before telling me that I had to start taking the medication. The pneumonia was a worse predicament than possibly having a reaction to the gluten. So, this lower-cost alternative still cost me $56, but well, that's better than the original price.

Roughly 24 hours after I started taking the medication, my good friends at the Drug Information Center at St. Johns University College of Pharmacy were able to verify that the drug was gluten-free and safe for me to continue taking.

So, what's the moral of the story? First of all, we desperately need health care reform in the United States so that everyone has access to quality, affordable coverage. We need regulation of the insurance industry so everyone with celiac and other chronic diseases can have easy access to safe, gluten-free medication at the same prices as other drugs. Until that happens, here are a few great resources that will help you quickly determine the gluten content of medications:

Gluten-Free Drugs:
a site maintained by Columbus Children's Hospital
www.glutenfreedrugs.com

American Society of Health System Pharmacists
An organization of 35,000 pharmacists working in hospitals, Download the Gluten in Medications Flyer for information about how you can help your pharmacist and doctor find safe drugs.
www.ashp.org

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