Your Pharmacist Does NOT Have a Right to Change the Rx to a Generic!

Stories have been coming out from consumers regarding how their pharmacist changed their prescription to a generic -- and this was done without telling them, and without asking their permission!

This has led to some horror stories of inadequate medication in the bloodstream for an epileptic. Her pharmacist, she learned, had exchanged her Tegretol for a generic that worked a little differently. "Just imagine what could have happened had I been behind the wheel of a car," she says. Luckily she was on a bicycle and while she sustained serious injuries, at least there was no fatality.

Pharmacists are so afraid of running afoul of insurers' pressure to use generics that they mistakenly tell patients that it is the law that they do so. Under a practice called "therapeutic substitution", pharmacists may substitute a generic for a brand-name drug even if your doctor specifies the brand name.

According to an article on MSNBC:

A pharmacist legally switched a drug prescribed by her doc — but without telling her or her physician. Usually, pharmacists replace a brand-name drug with a generic formulation of the exact same medication. Therapeutic substitution is similar but with one crucial distinction: The new drug is in the same class as the old and treats the same condition, but it's not precisely the same medication.

To understand the nuance, think of statins. They constitute a single class of medication because they all lower cholesterol by reducing its production in the liver. But not every statin lowers cholesterol by the same amount or with the same balance of LDL to HDL. So if your doctor orders a brand-name drug but your pharmacist switches it for the cheaper version of a different medication (but still a statin), you may not get the precise benefit your doctor had in mind — and may, in fact, suffer unexpected side effects.

This is horrendous -- we are all in favor of lower drug costs and in favor of using generics where appropriate, but no pharmacist should ever spring a surprise on any customer.

To read the whole article you may go here: http://www.msnbc.msn.com/id/30627962/
In one way, at least, patients can benefit from substitution — smaller co-pays. But two-thirds of people who reported having meds switched in a National Consumers League survey said they weren't consulted. Of those, 40 percent said the new drug was not as effective, and a third said it had more side effects. "It's not okay for your insurance company or pharmacist to change your drugs without your knowledge," says NCL Executive Director Sally Greenberg.

Is it Right that Insurance Companies are Profiting from Smoking Twice?

A Canadian newspaper recently ran a story investigating how much insurance companies have invested in the tobacco industry. The June 5 issue of The Province found that Sun Life, a major Canadian insurance company, has a billion dollars invested with two tobacco companies. About $890 million of that is in Philip Morris. And the insurance industry as a whole has over four billion dollars invested in tobacco.

This brings up not only a question of business ethics, but of sending a mixed message to the public. Insurers have penalized smokers with higher rates for every type of insurance, and yet they continue to invest heavily in tobacco.

Clearly they place a higher value on profits, and obviously tobacco has been a steady producer of profits for investors of every size.

As long ago as 1995, we have known that insurance companies were rather heavily invested in tobacco. That is the year that Lancet ran an article on the subject. Insurers profit twice from tobacco: once from the higher rates charged to smokers, and again from their tobacco stock holdings.

The Province article also states that Prudential, which sells health and disability insurance, has $1.38 billion in two tobacco companies, including British American Tobacco (BAT).

Northwestern Mutual (NML), Massachusetts Mutual and the Scottish firm Standard Life also have large holdings in tobacco firms.

Do we as consumers have a right to criticize insurers for having these investments, whether or not we hold stock in the insurance companies? Or is tobacco such an old and traditional social vice that it is useless to rail against it? Remember that Prohibition against alcohol did not work.

We can simply choose to not invest in companies that invest in industries we do not want to encourage. We can simply choose to invest in green, sustainable industries and companies.

The article may be read at: http://www.theprovince.com/Health/Canadian+life+health+insurers+investing+heavily+tobacco+companies/1664704/story.html