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Tuesday, June 10, 2014

New and Improved!

First, if it's new, it never existed so you cannot have improved upon it.
Second, if it has been improved, it already existed in some other form upon which an improvement took place. Comprende?

My question, the one with which my brain grapples, is: "What happened to yesterday?"
Today there are new "IT" drugs. Today there new medications to help treat conditions for which we already had a multitude of options. Yesterday was pretty good too. But why is today so much better than yesterday? (I'm not talking about revolutionary developments like vaccines or entirely new classes of medications.)
Doxycycline came out and was good for dermatologists. Then came Doryx and Oracea and doctors said it had to be brand. Then came Solodyn and doctors said it had to be brand.
First came Aldara cream, then the generic, then came Zyclara which must be better because it costs so much and isn't generic.

When medications need a prior authorization, prescribers tell patients to sign up for a manufacturer discount card or they have to pay for it. Why? Yesterday, the "IT" drug worked just fine according to these prescribers. Since the shiny new brand drug was approved today, how did this render the old drug obsolete?
Did yesterday's drugs lose all potency? Did they just stop making them? What happened to yesterday?

What did you prescribe last week?
Why did it change today?
What makes this so much better?
Dermatologists are by far the worst.
First they prescribe medications with DAW written all over them. Then, when a new drug (rep) comes along, they all switch to prescribing it. They send the patients to us with handfuls of discount/copay cards and tell them "you shouldn't have to pay too much at the pharmacy. Our drug rep told us so." Except that the prescribed drug needs prior auth on your primary insurance which is required before the copay card can work.

My questions are these: What did these doctors prescribe last week?
What did they prescribe last month?
Last year?
Last decade?
Last century?

The one-time "latest greatest thing" has now become an afterthought, supplanted by Big Pharma marketing dollars and flashy drug reps with copay cards who can't even bring me Starbucks anymore.
Today's Doryx 200mg and Epiduo are tomorrow's Monodox and Retin-A.

In some cases, the media are not helping. With the new 4-strain flu shot available late last winter, everyone was clamoring to get them. My problem is, there were not enough of these shots readily available for everyone to find them and people were turning away from getting the original flu shot in the hopes they would find the 4-strain.

They are likely to go unvaccinated if their search for this new shot proves fruitless. That is bad. While it is nice to have the option for a better flu shot, it does not mean the other one is not going to work.

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