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04/06/2017    Paul Kesselman, DPM

The High Cost of Drugs and Patient Adherence( David Secord, DPM)

When Medicare Part D first was announced, I was
asked to research and write an article on the
subject. To my astonishment and much to my
chagrin, the pricing of drugs was not set by the
government but by private insurance carriers and
the industry. This and other issues such as the
donut hole, deductibles, etc. have left many
seniors in a position of having to choose from
food or medicine.

Many split the doses of medications which may
have not been engineered for such a procedure.
Some I am told even end up in the ER due to the
untoward toxic effects of the resulting higher
blood levels of drugs as a result of self-
regulating their drug intake. Far too frequently
we see patients either skipping doses, failing to
fill prescriptions all of which result in
therapeutic failures and ultimately wasted
dollars on medical treatment(s) which should have
been avoided.

Recently another physician provided a family
member with a prescription (both brand and
generic) which were not covered at all by our
drug plan. In speaking with friends, family,
colleagues and patients this is an all too
frequent occurrence where also the "equivalent"
medications were not recommended by their

Many colleagues suggested that I embark on a
research mission to find the brand name
medication(s) abroad which took only a few
minutes. I veered away from any sites based in
third world countries and stuck to those drugs
manufactured in western European countries. In
only a few minutes I found several reliable sites
for modern Western culture countries where not
only was the brand name FDA approved drug
available in sealed boxes it was guaranteed to
have been manufactured in the western country
where the brand name manufacturer was located
with them guaranteeing that same/similar lot
numbers were shipped directly to the USA for
outrageous pricing. In some cases, the price
including shipping was 1/4 the price of the USA.

In essence, in the more than a decade since
Medicare Part D was formulated, it and other
prescription plans have not gotten better but far
worse. Access to medications has gotten worse
with premiums continuing to rise and many
medications removed from formularies. It is time
that the voters of this country put politics
aside and tell their representatives that they
simply are not going to tolerate this any
further. Simply put, put politics aside and
provide us with a health bill that is fair to us
(and not to the manufacturers). If not simply let
them know they can find themselves another job.

Paul Kesselman, DPM, Woodside, NY

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