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FAQ: How Can I Find The Best Price On A Prescription Medication?

1/19/2013

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It is common knowledge that certain prescription medications are very expensive.  This is especially true if it is a newer medication or if it doesn't have a generic form.  This doesn't mean that generics are always easy on the pocket book.  Generics can run high as well.  So, how can you find good prices on medications?  What are your options?
  1. Tell your doctor that you need financial help.  Doctors often have samples.  With all of the new anticoagulants on the market, you may be lucky.
  2. Ask your doctor about manufacturer low income programs.  Most manufacturers have some type of financial aid available for those without insurance.
  3. Ask about generics.  Generic warfarin is VERY inexpensive.
  4. Try good old fashioned warfarin rather than newer medications.
  5. While buying from other countries is illegal, the U.S. typically overlooks individuals who purchase abroad.  Make sure that your pharmacy has some accreditation and that they have a real pharmacist that requires a prescription from your doctor.
  6. If you are in the hospital, a social worker may be able to help get that Lovenox prescription filled. When I was being discharged, a social worker came and got my insurance info to confer with my insurance about how I was to get Lovenox.  I didn't have to do a thing.
  7. Write an appeal to the insurance company.
  8. This is my favorite!  Use one of the new, Internet price comparison sites.  I use www.goodrx.com for migraine medication when I have hit my insurance company's maximum for the month.  I have seen the price go from over $200.00 to around $35.00!  They show the prices in your area and provide discount coupons if needed to get the price.

Here are some other interesting thoughts on prescriptions for pulmonary embolism treatment for you. Some people will find certain brands of a generic medication to work better for them.  If this is the case, your doctor can specify on your prescription to ONLY give you a certain brand or to give you any generic BUT a certain brand.  I do that with my Wellbutrin generic.  It was much easier ad cheaper than fighting to use name brand Wellbutrin.  The brands are listed on your prescription bottle or you can often look up a pill online using a search engine and the pill's label, number, color, or markings.

If you need brand name Coumadin or you need another medication like one of the newer anticoagulants and your insurance won't pay, first have your doctor's insurance representative call to ask for an override based on medical need.  If that doesn't work, ask your insurer for the address of the appeals department and write the letter.  Your doctor can help you to make sure you have a solid, well informed letter.
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FAQ: What Is The Difference Between Factor V Leiden And APC Resistance?

1/11/2013

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This is a great question. Let me explain the alphabet soup for you. First off Protein C and Activated Protein C are different. Protein C must be activated before it can do its job. Once it is, it becomes activated protein C. 

Factor V is another clotting chemical. It causes clotting. Typically, Activated Protein C turns off Factor V. This means it would stop the body from clotting. The Factor V has a receptor that is the same shape as the Activated Protein C. It is like 2 puzzle pieces fitting together. Once the two pieces are together, clotting cycle stops. When you have the Factor V Leiden mutation, the Factor V Leiden puzzle pieces are shaped incorrectly. The Activated Protein C can't fit with the Factor V. 
Most people only have one copy of the mutation (from one parent rather than both parents) this means that about half of the Factor V is produced with the right puzzle piece and the other half is wrong. The part that is wrong is RESISTANT to the Activated Protein C. 95% of people with APC resistance have it due to Factor V Leiden. 5% of people with APC resistance have it due to other causes. All people with Factor V Leiden have APC resistance but not all people with APC resistance have Factor V Leiden.

You can also be short of Protein C, but this is not related to APC resistance. Protein C deficiency is when Protein C is affected before it is activated. You don't have enough Protein C to turn off all of the Factor V in your blood.

APC resistance, Factor V Leiden, and Protein C deficiencies all are types of thrombophilia (clotting conditions) and raise the risk of blood clots.  A patient can have one or more than one of these conditions, for this reason doctors will measure levels of protein C and Activated C Protein, do a APC resistance blood assay, and a genetic test for Factor V Leiden.  The more conditions that are found, the higher the risk is of having a blood clot.

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Swiss Health Insurer Vs. Yasmin

1/9/2013

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According to Yahoo News, A Swiss health insurer is baking a woman and her family as they sue Bayer, the creator of Yasmin.  Yasmin is one of the third generation birth control pills.  The third generation pills have come under fire for their use of newer progestins that appear to have a much higher risk of blood clots.  In the United States, Bayer has already paid out $750 million to just under 3,500 individuals who feel that they suffered a pulmonary embolism due to the use of Yasmin.

Combined oral contraceptives are a known risk factor for pulmonary embolism.  Individuals who have had a pulmonary embolism and would like to use birth control should speak with their doctor(r) about the options.  More information can also be found by clicking here.
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Asthma Increases Blood Clot Risk

12/28/2012

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On 12/20/2012 an article came out with new information about risk factors for blood clots.  The newest risk that researchers have pinpointed is asthma.  According to the article, "people with severe asthma were almost nine times more likely to develop a PE compared to people without asthma."  This means that people who are already struggling with lung problems are at risk for even more lung problems.  This article doesn't mention any thoughts as to why the risk goes up when someone has severe asthma.  One can hope that if the asthma is managed that the risk will drop.  Only time and more research will let us know the answers to that question.  This is only preliminary research.  More studies need to be done to see if this effect is repeated.  To read more about the study see: http://www.irishhealth.com/article.html?id=21484#.UNMBDo-zOWw.facebook
3 Comments

FAQ: When Should I get tested For Clotting Conditions?

11/30/-0001

 
After a blood clot tests can be run to determine if you have a condition that makes your blood clot more easily than the majority of the population.  These conditions are often referred to as clotting conditions, thrombophilia, or hypercoagulable states.  Testing for these conditions will not be able to predict who will and will not have a clot.  About half of the people who have a clot will have no known cause.  This means that the blood work would show no clotting conditions.
Testing for thrombophilia is useful when deciding the length of time a patient will be on anticoagulation.  The problem with anticoagulation is that it is risky.  You only want to be on anticoagulation if the risk of clotting is larger than the risk of a life threatening bleed.  Testing for thrombophilia will give you more information so that you and your doctor can determine which risk is more acceptable for you.
To determine if thrombophilia testing is right for you, you should:
Think about your history, the costs, risks, and benefits.  Medical testing seems harmless but it can have unwanted effects.  If you need help deciding about testing please talk to your primary care provider and consider requesting a hematology consult.  Feel free to get a second opinion.  Many times doctors will write off a clot as a simple case of birth control pills, weight, or travel when there might be more to the story.  If you haven't experienced a recent major risk factor there is a good chance that there is more to your clot's story.
  • Ask your doctor if having thrombophilia would change his or her recommendations about the amount of time that you will take anticoagulation medications.  If the test will not change treatment, the test is not needed.
  • Talk with your doctor and insurance agents about the impact the findings may have on your ability to obtain life insurance.
  • Consider your age.  Many recommendations state that individuals under the age of 50 that had a DVT or PE without a significantly large risk factor (abdominal surgery, bed ridden, cancer, or other major risks) have tests run to see what may have caused the clot.
  • Consider your risks.  Can you and your doctor identify any MAJOR risks?  A major risk may be able to be eliminated so that the clot doesn't repeat.  If you only had a minor risk (weight and birth control are examples) there is a good chance that something else contributed to your clot.
  • Ask your medical team what they feel are typical, minor, and major risks for blood clots and figure out where you fit into that list.
  • Consider what risks will be in your future.  Are you thinking about birth control, infertility treatments, cancer, hormone replacement, frequent long haul airplane trips, or any other big risks?  You may want to know if you have a clotting condition that will further put you at risk.
  • Is there a family history of clotting or miscarriage?  Let your doctors know!

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