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Author Topic: Does Your Doc Push Expensive Meds?  (Read 828 times)

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Offline MitchMiller

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  • Posts: 630
Does Your Doc Push Expensive Meds?
« on: March 21, 2020, 08:25:57 pm »
I finally reentered care after more than a 12 year hiatus.  I've been HIV+ since 2001.  The first thing the doc said was that my meds were really old and I should consider switching.  I'm taking Sustiva 400mg (2 Sustiva 200mg capsules) + Epzicom.  He suggested Joluca.  A quick search on Joluca's cost yields:  The monthly cost for Juluca oral tablet (50 mg-25 mg) is around $2,837...

I buy my meds from a foreign pharmacy for a total cost of $175/month.  I will be using Medicare in 18 months.  My viral load test is undetectable < 20 as of 3/19.  I don't want to switch to anything that will stress my limited fixed retirement income. 

In a head-to-head test of Sustiva 600mg vs Rilpivirine, Sustiva was found to be non-inferior.  The only reason to switch would seem to be cholesterol levels, but the doc didn't know mine.  I'm assuming a head-to-head using a 400mg dose of Sustiva would yield even better results.

I'm wondering if docs are getting some sort of under-the-table "benefits" for prescribing expensive new meds, when older meds work just fine.   Has anyone else ever gotten the impression that their doc was pushing expensive meds without good cause?
« Last Edit: March 21, 2020, 08:38:40 pm by MitchMiller »

Offline harleymc

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  • Posts: 1,381
Re: Does Your Doc Push Expensive Meds?
« Reply #1 on: March 21, 2020, 10:57:43 pm »
If you want to stay on your generics no-one is forcing you to change.

I'd be pretty cautious of speculating on someone's motives, especially where there would be an implication that your doctor might be breaching professional ethics. Why don't you ask two simple questions to your doctor.

Do you get a kickback?
Why are you suggesting the new medication.

Having spent more than ten years out of care, sounds like you have some trust issues with the health care industry.

Offline Grasshopper

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  • Posts: 624
Re: Does Your Doc Push Expensive Meds?
« Reply #2 on: March 22, 2020, 03:38:52 am »
NO, i don't have that impression.

Offline MitchMiller

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  • Posts: 630
Re: Does Your Doc Push Expensive Meds?
« Reply #3 on: March 24, 2020, 12:57:41 am »
Harley:  I will ask why he suggested the change during the next appointment, but in the initial conversation he stated that now there were new medications that address issues with old meds, like bone loss.  However, bone loss isn't a major problem with my regimen.  At any rate, the switch is unaffordable for me so it's a no-go.  Can't get blood from a rock as they say!  and generic availability seems to be growing.  I see there is now a generic Bictarvy; generic Dolutegravir has been around for at least a year... so I can create my own generic Dovato; and could even substitute Sustiva for Rilpivirine to create a regimen like Juluca.

And yes, I do admit I'm a skeptic as much with the medical establishment as I was with auto mechanics when I used to own a car. 

That major reason for being out of care was inability to acquire insurance prior to Obamacare, and later to save $$$.  As I'm getting up there in years, I figured it's time to rejoin care.  I was cringing today as I looked at all the blood tests that were done during my first appointment from my online patient record.  I'm expecting to be about $2000 poorer after I get that lab bill.  At least everything looked pretty much like it did 20 years ago.
« Last Edit: March 24, 2020, 01:09:50 am by MitchMiller »

Offline Mojito

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  • Posts: 47
Re: Does Your Doc Push Expensive Meds?
« Reply #4 on: March 28, 2020, 10:10:42 am »
I was on medicine for which I had to pay from my own pocket. My doctor put me on free medical plan from government and now I don't need to pay anything for medicines. The only amount I need to pay is the half yearly CD4 and viral load test.

 


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