01/18/2023

'Just Say No' to the Medication Switches

It's time to stop letting insurers dictate what we can prescribe to our patients.

No. Just no.

As the start of the new year has come around and gone, I'm sure you all, like me, have been inundated with the ritual beginning of the year change of prescription requests.

• "The Lantus (glargine insulin) that you prescribed for Mrs. Jones is no longer covered by her insurance; please change it to Basaglar (glargine insulin), which is covered and the new preferred formulation."
• "Patient's Xarelto, a direct oral anticoagulant, is no longer being covered by their insurance plan this year; please change them over to warfarin."
• "Your prescription for Mr. Smith's Valsartan is no longer valid; it was rejected when he attempted to fill it at the pharmacy. Please change to an alternate covered therapy."
• "The mesalamine that your patient has been using for 20 years now has a $600 co-pay; please change her medication to something -- anything -- else."

All very nicely worded, all very polite, and all completely ridiculous. This process highlights just one more example of how we have let ourselves be railroaded into being told how to take care of our patients.

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