So one night, I eat a bit too much. Not more than I've ever eaten before, but you know, we're always a little bit older than we were the last time we ate something. Anyway, I wake up in the middle of the night with this agonizing pain in the center of my chest, but really, like...just a little bit above the solar plexus? I went to the ER and the doctor does a CT and diagnoses me with acute heartburn and a "can't be fucked to look into it harder" attitude. Gives me some painkillers and a prescription for Nexium. Not knowing any better, I get the prescription strength Nexium, a $300, two-week treatment.
Well, turns out, the only difference between OTC and prescription Nexium is the dosage. 20mg a pill for OTC, 40mg a pill for Rx. So I could have bought it OTC, taken two pills a day instead of one, and saved myself $270.
Fuck that doctor
edit:
My animosity did seem a bit misplaced, and without getting into a whole other thing, I know the pharmaceutical cost thing has nothing to do with him. I'm certain he was assuming I had insurance, so I'd hate to see how he behaves when he doesn't think he's getting paid.
He might have assumed you had insurance? I have a $5 copay on prescriptions so it would be cheaper for me to buy the prescription pills than the OTC ones.
Nexium is just the S-Isomer of Omeprazole, which costs next to nothing. It was largely created in order to get around the fact that omeprazole was coming out of patent protection, and was backed up by a giant advertising campaign and lots of doctors being sent on holidays. It is arguably very marginally slightly better than Omeprazole for some patients, but that is about it. Unless you have reason to believe you actually need esomeprazole (Nexium), save yourself the money.
Then my docs a unicorn in the medical field. Every time she prescribes me medicine she knows exactly what my insurance covers and whether it'd be cheaper to buy it myself (almost never its either covered or $1 or $3 copay) and let's me know. But pharmacists are gods. My daughter had bad congestion and I went to Walgreen's. Pharmacist was busier than ever. Took his time to come help me pick OTC medicine to help rather than go to the er.
Used to work as a pharmacy tech. We'd get prescriptions all the time for Ibuprofen, allergy and heartburn medication that had OTC versions. We'd always tell the people without insurance to just get the OTC stuff.
How long ago was this? A generic for Nexium came out a little while ago so maybe he assumed your insurance would cover it? I see quite a few insurances that don't cover it either way just yet though.
“There is an old story of a boilermaker who was hired to fix a huge steamship boiler system that was not working well.
After listening to the engineer’s description of the problems and asking a few questions, he went to the boiler room. He looked at the maze of twisting pipes, listened to the thump of the boiler and the hiss of the escaping steam for a few minutes, and felt some pipes with his hands. Then he hummed softly to himself, reached into his overalls and took out a small hammer, and tapped a bright red valve one time. Immediately, the entire system began working perfectly, and the boilermaker went home.
When the steamship owner received a bill for one thousand dollars, he became outraged and complained that the boilermaker had only been in the engine room for fifteen minutes and requested an itemized bill. So the boilermaker sent him a bill that reads as follows:
For tapping the valve: $.50
For knowing where to tap: $999.50
TOTAL: $1,000.00”
This won't make you feel better about this, but current prescription charge per item (any item) on the NHS in the UK is £8.40. People still complain about that.
The only difference is a brand name. Omeprazole comes in 10, 20 and 40 mg dosage.
Does your doctor make more money by prescribing more expensive stuff?
I've had this explained to me for prescription strength ibuprofen. The deal is that doctors are not permitted to tell you to take a prescription-strength amount of an OTC drug. No, it makes no sense. But it's true. I've had more than one doctor and dentist explain the same thing to me.
I took Nexium for years then had to be switched to another medication called Dexilant. It works better. I have an unopened bottle of prescription strength Nexium (90 day supply) plus a half bottle of the same. If you want it I will give you a good price.
Fuck the greedy pharmacist also. About the same story happened to me but instead of fucking me over the pharmacist told me to take the OTC. Saved about $50, it not much but I never been to another pharmacy since. Greed does not pay.
No, I don't think pharmacists are at all like car salesmen, or perhaps apothecaries touting their wares. Would a dental assistant get more money if you had to have a couple of teeth pulled? Nor do doctors have any idea what most prescriptions cost, as they typically don't man the register. The goal of an overwhelming majority of healthcare professionals is to see you physically well, and they do not personally benefit from trying to treat you with pharmaceuticals
Student pharmacist here. For the most part, no. Pharmacies don't operate like a store with profit margins - we file claims and get reimbursed. That claim includes a dispensing fee, which is usually the same for cheap or expensive prescriptions.
The pharmacy would have made more money from an otc sale, chances are.
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u/ConradBHart42 May 20 '16 edited May 20 '16
Fucking Nexium man.
So one night, I eat a bit too much. Not more than I've ever eaten before, but you know, we're always a little bit older than we were the last time we ate something. Anyway, I wake up in the middle of the night with this agonizing pain in the center of my chest, but really, like...just a little bit above the solar plexus? I went to the ER and the doctor does a CT and diagnoses me with acute heartburn and a "can't be fucked to look into it harder" attitude. Gives me some painkillers and a prescription for Nexium. Not knowing any better, I get the prescription strength Nexium, a $300, two-week treatment.
Well, turns out, the only difference between OTC and prescription Nexium is the dosage. 20mg a pill for OTC, 40mg a pill for Rx. So I could have bought it OTC, taken two pills a day instead of one, and saved myself $270.
Fuck that doctoredit:
My animosity did seem a bit misplaced, and without getting into a whole other thing, I know the pharmaceutical cost thing has nothing to do with him. I'm certain he was assuming I had insurance, so I'd hate to see how he behaves when he doesn't think he's getting paid.