Friday, July 11, 2008 doyle kelly asks

Q: Drugs and possible adverse effects due to takeing multiple drugs used to treat the same condition

I was diagnosed with severe emphysema stage 4 in August 2005. My initial medications were. Spiriva-1 daily, Advair Diskus 250/50-2 daily, Theophylline 400mg-1 daily,Prednisone oral service pak-1 every 60 days, Albuterol Inhaler-as needed. This was my routine untill March 2007 when I lost my insurance. In August 2007 I was given a prednisone 20mg RX

for 150 pills.Which I used on a as needed basis. In May 2008 With the start of my disability I

Had to get a new Pulmonary Specialist and start my meds over now I'm on Spiriva,Advair,Theophylline,Terbutaline 2.5mg 3 daily,Albuterol Sulfate Solution0.083% at 4 time s daily,Albuterol Inhaler. My problem is my insurance is refuseing to authorize the Spiriva because "THE MEDICATION COULD NOT BE AUTHORIZED BECAUSE OUR RECORDS INDICATE THAT YOU MAY BE RECEIVING MORE THAN ONE MEDICATION THAT COULD BE USED FOR THE SAME CONDITION. THIS COULD LEAD TO A POTENTIAL ADVERSE EFFECT ON ONE'S HEALTH" I trust my doctor and I have always had great faith and trust in my pharmacist for the past 20 years and neither one has warned me of any danger. So what do you think is there a possible danger? Or is the insurance company just trying to save a buck?

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Answers (1)

Martin Cane, M.D., Health Pro

7/11/08 10:30am

doyle kelly,

Thanks for your question which brings up a common problem. Insurance companies have a computerized system that checks medications for cross reactions as well as indications. If more than one medication is used for the same purpose, the computer might flag this and refuse to pay.

This is not an issue with your pharmacist or your physician's practice methods. This is an issue with the insurance company.

People with complicated problems like yours often require multiple medications to achieve control of their problem. Bring this to the attention of your physician. Often, a doctor can contact the pharmacist and explain the need for the multiple medications. Sometimes, a form is provided for the physician to document their treatment and reason for the multiple medication choices. In some cases, the physician may be able to choose another medication that will serve the same purpose.

Unfortunately, there are times that the insurance company has the final say and still refuses to pay for the prescription. In this instance, your physician may be able to find a cheaper generic that can be used (and that you will have to pay for).

Best wishes.

Martin Cane, M.D.

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Q: Drugs and possible adverse effects due to takeing multiple drugs used to treat the same condition

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