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Join with me in Growling at THE WAY THINGS ARE!!

GRRRRRRRRRR!!


The World is Displeasing in this follow ways:

I. BIOEQUIVALENCE ... I take and have taken a name-brand prescription medication for a chronic condition for over 5 years now. Up until recently, my home state's pharmacy assistance program was able to help me with the cost. In the recent past, they have switched from covering the name brand to covering the generic. I tried the generic. I've not got the money to complain. It did not function as the name-brand did. I was told by one Doctor that that can happen--that the generics are not the EXACT same as the name-brands and do not always work the same. In fact, that the drug I was having issues with was one they'd heard the complaint about before! From another Doctor--I was told that generic IS EXACTLY the same!

I have a tendency to get carried away, so now i'm doubting my own sanity. If the pills are in fact the same, and i did not react the same, were all the effective years of treatment merely expensive and inconvenient placebo-effects?

I went to the Int0rWebs!

Where I learned about BIOEQUIVALENCE. Apparently, in order to be a 'generic,' a drug must contain the active ingredient of the name brand drug. And be SIMILAR in effect, dose, and side effects. In fact, the FDA sets up a window of "HOW similar" in clinical trials.

So. I'm not insane. The drugs are NOT identical. Chemically, there's a molecular weight different of over 30 grams per molar volume (and yes, the generic is the lighter one b/c they threw stuff out.)

However, as far as my pharmacy assistance is concerned--since the drugs have been shown to be BIOEQUIVALENT with a margin of error in reasonable bounds, the drugs are CLOSE ENOUGH to identical for ENOUGH PEOPLE that if I'm not one of them, who gives a fuck.

what i've been taking for years that works!:C^13H^18ClNOHCl
what the FDA and the Pharmacy Assistance Program people will give me: C^13H^18ClNO

notice that the hydrochloride on the end of that is missing in the generic. HHHHhmmmmm.


II. FALLING DOWN STAIRS... Last Tuesday I slipped on some carpeted stairs inside of an apartment building. I had to go to the ER. I had to get Xrays. I have to schedule a follow-up appointment. I've missed work. I HAVE NO MEDICAL INSURANCE. My Grandfather told me that I should speak to the owner of the apartment building. I fell on their stairs. There was no banister. Their carpet was slick. I hurt myself on their crummy hallway.

I contacted the property manager who said that the building was up to code so basically i could go fuck myself. But that if i wanted, i could send a letter to their attorney and maybe something would come it. "Maybe" meaning "The building owner would sooner get a glass-shard enema than file with his insurance company over your dumb peasant ass."

I'll be writing their lawyer.


III. PHOTOGRAPHY... The photographer who took the Bolk's picture and has been emailed repeatedly about which photo they wanted from his proofs claims that he did not know what proof they wanted and la la la. That, beyond being highly irking, was easy to resolve. The Bolks and the Moores will be getting their Christmas present from the past 3 years in another week or two.


IV. TRANSPORT!... I have so many errands to run, but Aunt will not let me drive just yet. So they go undone. And I feel like a lazy ball of useless. And I ACT like a lazy ball of useless. I miss the gym. I miss my car. I miss... being independent. The foot is well enough to wander around on, but not for long and certainly not with any athletic intent.


V. DESK!... buried under paper. I go file and sort and balance checkbook now.
location: home. desk.
The Colony Magistrate Says : Canada is Really Big --Arrogant Worms
Mood in the Settlement: 'frustrated' frustrated
There are 17 Letters from home. (Post a letter from home.)
 
posted by [identity profile] hyrina.livejournal.com at 11:09pm on 17/07/2007
Poor Kya! I swear, EVERYONE is having a shitty year this year! I hope it all works out for you! *hugs*
 
posted by [identity profile] xerahanadu.livejournal.com at 12:37pm on 18/07/2007
*hugs* Thank you, hyrina. Though I swear--I cannot call this year bad. I could have BROKEN my foot or died in a freak lawn bowling incident. i mean... really. If the worst that happens is me having to write letters to people? So be it.

...this may be dumb of me b/c lord knows, i've not been online as much during this half of the summer... but i've not seen you around for a while. Are you okay?
 
posted by [identity profile] hyrina.livejournal.com at 12:44pm on 18/07/2007
I'm alright. I've seen you on AIM when I get on but I've been having to run off the comp entirely a LOT. See, I'm getting phone calls from a friend of mine daily and can't stay at the comp because I can't HEAR over the TV out here. So I run away and that really sucks cause I haven't been able to DO ANYTHING lately. I mean, talking on the phone's been great, so I wouldn't give it up. Just yeah. Haven't been at my comp. It's obnoxious. And well... I have more and more shit piled on me daily. But I'll live.
 
posted by [identity profile] cynlee.livejournal.com at 11:31pm on 17/07/2007
I don't suppose your doctor could be persuaded to get the home state assistance program to go back to approving your original meds? I thought that sometimes the doctor could interfere.

I hope you can get out and about soon.
 
posted by [identity profile] xerahanadu.livejournal.com at 12:40pm on 18/07/2007
the doctor can submit petitions, but they can't force the issue. They have to give a reason why the brand name is medically necessary. Which, you'd think that "The Generic Does Not Work On My Patient" would do it.

The hiccup? The Doctor that INSISTS that generics are IDENTICAL to the brand name? He's the doc writing the scripts. grr. Yes. I'm considering switching Doctors.
 
posted by [identity profile] skeletoncrew.livejournal.com at 11:32pm on 17/07/2007
*hugs* I hear you on the generic thing, my mom has had similar issues, though I don't remember which meds offhand.

Good luck with the lawyer letter. Worst case, maybe you can get the hospital to write it off?

As for the lazy feeling, I've been doing that far too much lately. It looks like our cramped apartment is going to be HQ for our 48 hour film project team this year, which means I need this place as clean and organized as possible. We need some sort of taskmaster or something. Someone other than Mike or I who can make us both work at the clean-up without one of us being "the nag." Oh, and while I'm wishing I'd like a pet miniature unicorn that eats hay and shits pure gold.
 
posted by [identity profile] xerahanadu.livejournal.com at 12:48pm on 18/07/2007
Out of Curiosity, How does one "get the hospital to write it off"?

Taskmaster? Hah!

That brings me to my idea for a PROFESSIONAL MOTHER-SERVICE. The Mothers do NOT take care of SMALL CHILDREN. Only adults. They fix a good, healthy meal for you, they dote on you when you're sick, they give you a basis for organization with a one-time (or yearly) FULL CLEANING--then help you spot clean weekly, and then if necessary can be requested to "be the bad guy" for naggings that must be done around the house.

A.K.A. a butler/personal assistant with nagging rights.

Oh. And you get a healthy breeding pair of those miniature unicorns, lemme know. I'm interested in procuring one.

 
posted by [identity profile] greenwillow27.livejournal.com at 11:59pm on 17/07/2007
Sounds like out MediCal program. Sometimes it seems like it's more about *looking* like they are providing medical assistance than actually doing it.

"Need fifteen stitches? Meh...we'll cover seven and a half." =o[
 
posted by [identity profile] xerahanadu.livejournal.com at 12:55pm on 18/07/2007
yeah... i was really happy that i qualified for Pharmacy Assistance. In the past, it's been a god-send. But now, it only helps with one of my two full-time prescriptions. Which is CERTAINLY better than nothing! I'm not too good for THAT!

But they made a big deal out of adding Patient Care (some acronym) but basically, i've got a General Practitioner now that i can see--and they cover Dental. I was THRILLED! Surely if they're covering my TEETH, they'll cover that trip to the ER, RIGHT?

No.

Head Colds, yes. Tooth Cleaning, yes. ACTUAL EMERGENCIES?! fuck no! those are expensive!



Kevin and I recently watched "SICKO" and while M. Moore can be an arrogant butthole--he WILL give you some perspective. (That you have to double check some times b/c he tends to paint the picture a bit to the left of what it may ACTUALLY be. Cuba? Ranked below us in health care. But depicted in the movie as a medical utopia. ...still the facts about France's health care system were right.) Eh. It makes me wanna learn more about Canada.
 
posted by [identity profile] labrynthos.livejournal.com at 12:07am on 18/07/2007
FUCK generics.

I was on Desogen for years, no problems (BC pill). Then my insurance (Kaiser Perm) cheaped out and switched to Apri, claiming that it was the same thing. It was not. I spent a week out of work with migraines and constant vomiting. So I stopped taking it and didn't have BC until I had a new provider and I'm not gonna go into my BC saga from there - but the point is: That Sucks!
 
posted by [identity profile] xerahanadu.livejournal.com at 12:55pm on 18/07/2007
AMEN!
 
posted by [identity profile] lindentreeisle.livejournal.com at 12:19am on 18/07/2007
I am sorry property manager was not helpful. :( Somehow I suspected she wouldn't be...grar.

Good luck with the lawyer.
 
posted by [identity profile] xerahanadu.livejournal.com at 12:56pm on 18/07/2007
*nods* we talk more about this via im. or phone. or something. Your MOVE IS SOOOOOON!
 
posted by [identity profile] moonbeam-067.livejournal.com at 04:44am on 18/07/2007
I hope I'm not too forward in posting this here... but I wanted to offer some more info regarding your issue with generics.

All generics must have the same active ingredient. (This means that the chemical structure of the drug is exactly the same... so I am curious where you read that the active ingredient of the generic was missing the HCl. You should be able to find the chemical structure of the generic in the manufacturer's package insert.) However, the inactive ingredients/fillers/appearance of the formulation may differ (which is why bioequivalence studies are required by the FDA.) This also means that it is possible for people to react differently to a generic medication compared to a brand name medication (despite the fact that the active ingredients are identical.) I don't know how the prescription assistance plans work in your state, but sometimes doctors can submit something called a prior authorization. This usually involves some paperwork or a phone call to the plan explaining why you need the brand name medication. The plan then will review the claim and either approve or deny the request. If the request is denied, the doctor can appeal and submit a letter of medical necessity. Another option if you meet qualifications is to apply for prescription assistance from the drug manufacturer.

(And I also find it unacceptable that so many people in this country have no medical insurance coverage... but i won't get into that now.) Good luck writing the lawyer, and I hope you feel better soon.
 
posted by [identity profile] xerahanadu.livejournal.com at 01:05pm on 18/07/2007
*yearns for universal health care.*

and no, it's not too forward of you at all. :)

Chemical Structure and Systematic (IUPAC) name for Bupropion (my generic.) The Active Chemical in Wellbutrin XL. (http://en.wikipedia.org/wiki/Bupropion)

Complete Prescribing Information for WELLBUTRIN XL® (bupropion HCl extended-release tablets). From the GlaxoSmithKline Wellbutrin website. (http://us.gsk.com/products/assets/us_wellbutrinXL.pdf)

If I'm wrong in my int0rWebs gleanings, please, lemme know!

As for the doctor's petition--would be doable if my current doctor wasn't the one chanting at me that they are the exact same. Yes, I'm considering switching doctors. I'll talk to the receptionist/officer manager the next time I'm there and find out if there's another Doctor in the clinic willing to see me.

hoops! HOOPS EVERYWHERE! SEE HOW I JUMP THROUGH THEM!
 
posted by [identity profile] moonbeam-067.livejournal.com at 04:39am on 19/07/2007
Ok, I looked at both of the links you posted and I think I see where you may be getting confused. The Wikipedia link is just showing the chemical structure/MW of Bupropion in general (the active component in Wellbutrin, Zyban, and the generic formulations.) In all cases, the complete chemical formula has HCl added to the bupropion (probably to increase the solubility/absorption of the medication in the GI tract.) The FDA publishes a reference called the Orange Book which lists which generic medications are considered bioequivalent. http://www.fda.gov/cder/ob/docs/queryai.htm I don't know which generic product you received, but here is a link to a package insert for a generic by watson. http://pi.watson.com/data_stream.asp?product_group=1601&p=pi&language=E If the link works, you can see that it is the exact same structure and MW, but the inactive ingredients differ. (I don't want to get into too much detail, but I can explain further if you still have questions.) If you want to see the package insert for the specific generic you received you may be able to get it from your pharmacy or you can contact the manufacturer.
 
posted by [identity profile] dcs745.livejournal.com at 05:17pm on 19/07/2007
Honey, we HAVE a health care system... but our GPs prescribe by active ingredient and it's a matter of luck whether your pharmacist stocks generic or the Brand Name. Mind you... no matter which you get it's the same price (£6.85) to the consumer, so you can understand pharmacists stocking the cheaper one.

What's worse is that there are restrictions on the NHS -- for example one of the Alzheimer's drugs can only be prescribed for medium severity Alzheimer's, rather than mild stage to delay the progression to medium stage. (It's not a cure, but it slows down deterioration.)

And diabetes? They are switching from animal origin to synthetic insulin... and synthetic insulin does not control my brother's diabetes; his blood sugar ends up all over.

Basically, we're all screwed.

Foreign Marvels

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