Comments on: Combo pills do not save patients money http://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: JustADochttp://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html#comment-137800 JustADoc Thu, 08 Jul 2010 17:40:49 +0000 http://www.kevinmd.com/blog/?p=44749#comment-137800 I have one patient who told me I can prescribe anything I think necessary up to a 3-pill maximum. Why is that his limit? I don't know but it is. I asked which was more important: cost or the 3-pill max. The 3-pill max. He was willing to pay significantly more for ExforgeHCT than the very similar and cheap LisinoprilHCT and Norvasc. I have one patient who told me I can prescribe anything I think necessary up to a 3-pill maximum. Why is that his limit? I don’t know but it is. I asked which was more important: cost or the 3-pill max. The 3-pill max. He was willing to pay significantly more for ExforgeHCT than the very similar and cheap LisinoprilHCT and Norvasc.

]]> By: Doc Dhttp://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html#comment-137791 Doc D Thu, 08 Jul 2010 14:02:54 +0000 http://www.kevinmd.com/blog/?p=44749#comment-137791 I'd like to see a study (probably already exists) that looks at compliance with combo versus separate drugs, like the ARB-hctz example. I'll bet people who are compliant at taking one will be compliant with two, as long as they know both are for the same problem and both are needed. If you go to the trouble to make sure you take a daily pill, it seems reasonable to assume you'd take the pair. I think part of the compliance problem is multiple different regimens. (2 qid, 1 q6h, 1 hs, etc). But I could be wrong. I’d like to see a study (probably already exists) that looks at compliance with combo versus separate drugs, like the ARB-hctz example. I’ll bet people who are compliant at taking one will be compliant with two, as long as they know both are for the same problem and both are needed. If you go to the trouble to make sure you take a daily pill, it seems reasonable to assume you’d take the pair. I think part of the compliance problem is multiple different regimens. (2 qid, 1 q6h, 1 hs, etc). But I could be wrong.

]]> By: Edwardhttp://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html#comment-137775 Edward Thu, 08 Jul 2010 04:14:43 +0000 http://www.kevinmd.com/blog/?p=44749#comment-137775 In addition to the above many generic combo pills, e.g. lisinopril-hctz, generic for ziac, and others are on the budget pharmacies $4/ month lists. In addition to the above many generic combo pills, e.g. lisinopril-hctz, generic for ziac, and others are on the budget pharmacies $4/ month lists.

]]> By: Matthew Mintzhttp://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html#comment-137760 Matthew Mintz Wed, 07 Jul 2010 20:47:13 +0000 http://www.kevinmd.com/blog/?p=44749#comment-137760 Agree, but I would change the title of your post to "Combo pills may not save patients money." Your Lotrel example is true for patients who pay completely out of pocket (which can be a huge expense and why you developed leslieslist.org). However, many patients do have prescription benefits, where a generic co-pay is the same, regardless of whether the pill is a combination or not. Thus, a patient who has a prescription plan that charges $10 for generics would pay $20 for both pills and only $10 for the combination. Also, for some medications where part of a combo pill is a branded product where there is not a generic yet (i.e. Benicar HCT, Avandamet), Big Pharma (BP) usually throws in the generic for free, i.e. Avandia and Avandamet cost the patient who has a prescription plan (and sometimes the insurer) the same amount. Agree, but I would change the title of your post to “Combo pills may not save patients money.” Your Lotrel example is true for patients who pay completely out of pocket (which can be a huge expense and why you developed leslieslist.org). However, many patients do have prescription benefits, where a generic co-pay is the same, regardless of whether the pill is a combination or not. Thus, a patient who has a prescription plan that charges $10 for generics would pay $20 for both pills and only $10 for the combination.
Also, for some medications where part of a combo pill is a branded product where there is not a generic yet (i.e. Benicar HCT, Avandamet), Big Pharma (BP) usually throws in the generic for free, i.e. Avandia and Avandamet cost the patient who has a prescription plan (and sometimes the insurer) the same amount.

]]> By: GlassHospitalhttp://www.kevinmd.com/blog/2010/07/combo-pills-save-patients-money.html#comment-137758 GlassHospital Wed, 07 Jul 2010 20:12:13 +0000 http://www.kevinmd.com/blog/?p=44749#comment-137758 Good point, especially on the PrevPac. But for Medicaid eligibles in your state, the formulary includes many combination blood pressure medicines.Getting someone to take two pills in one is a lot easier (and easier for them to remember and swallow) than two pills. Good point, especially on the PrevPac. But for Medicaid eligibles in your state, the formulary includes many combination blood pressure medicines.

Getting someone to take two pills in one is a lot easier (and easier for them to remember and swallow) than two pills.

]]>