managing-insomnia

by Jenny Bingham, PharmD, BCACP
SinfoniaRx

What is insomnia?

The prevalence of insomnia increases with age, especially in women. Individuals can experience one of two different types: acute or chronic. Acute or transient insomnia lasts for days to weeks. Chronic insomnia lasts for more than one month. 1

A general consensus estimates that approximately one-third of adults experience insomnia. Characteristic symptoms include: difficulty initiating sleep, difficulty maintaining sleep, waking up too early, and/or poor quality of sleep. 2

Why is it important to treat insomnia?

Untreated insomnia can have negative outcomes on an individual’s overall health. It is been associated with altered physical health, emotional health, mental health, social functioning, pain control, and overall health perception. 3

What can you do to treat insomnia?

There are two approaches to treating insomnia without medications. 4

Sleep hygiene

  • Keep a regular sleep schedule.
  • Do not exercise immediately before bedtime.
  • Avoid alcohol and stimulants (caffeine, nicotine) in the late afternoon and evening.
  • Maintain a comfortable sleeping environment that is dark, quiet, and free of distractions.
  • Avoid consuming large amounts of food or liquids immediately before bedtime.

Stimulus control

  • Go to bed only when you are sleepy.
  • Avoid daytime naps.
  • If unable to sleep, get out of bed and go to another room— only return to your bed when you feel the need to sleep.
  • Do not eat or watch TV in bed.
  • Wake up at the same time each day.

Individuals should also ask their provider about management of other underlying causes of insomnia, like psychiatric or other medical conditions. It’s important to limit prescription sleep aids to short-term use. After initiating any treatment for insomnia, whether behavioral or prescription, it’s important to reevaluate after a few weeks.

References:

  1. Schutte-Rodin S, Broch L, Buysse D, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008; 4:487–504.
  2. Ancoli-Israel S, Roth T. Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. I. Sleep. 1999 May 1; 22 Suppl (2):S347-53.
  3. Katz DA, McHorney CA. The relationship between insomnia and health-related quality of life in patients with chronic illness. J Fam Pract. 2002 Mar; 51(3):229-35
  4. Dopp JM, Phillips BG, Chisholm-Burns M. Sleep Disorders. Pharmacotherapy Principles & Practice and. 3e; 41: 737-747.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.
If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!
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Controlling Your Fibromyalgia

by Kali Schweitzer, PharmD candidate 2018
University of Arizona College of Pharmacy

Dull, aching pain throughout your entire body. Trouble sleeping. Irritable mood. What could possibly be going on? Is it just in your head? Does anyone else feel like this? Well, if you experience some of these symptoms, one potential cause could be fibromyalgia, which affects the lives of almost 4 million Americans.

Fibromyalgia is a chronic pain condition that, while common, is not entirely understood or easy to manage.  Because the exact cause of this condition is not known, effective treatments are difficult to come across, and it’s common for patients to find themselves spending a lot of money trying to find a cure. Often times the suggested treatment is a combination of both lifestyle changes and medications. Ideally, by following the recommendations of your health care team and putting effort into your treatment plan, you will be in a good position to prevent your fibromyalgia from controlling your life and emptying your wallet.

Lifestyle Changes Can Help Fibromyalgia Symptoms 

First and foremost, physical therapy as well as certain daily exercises may be the key to keeping your symptoms at bay.  Suggested exercises include yoga, tai chi, walking, swimming, biking, and other low impact activities. Exercise has the potential to increase quality of life and reduce severity of pain over time.

Another way to improve your symptoms is sleep hygiene, which involves evaluating and making changes to some of your day time habits that may keep you from getting a good night’s sleep.  Some things to try include avoiding caffeine too late in the day and removing screens (phones, computers, televisions) from the bedroom.  By getting more quality sleep at night, you have the potential to majorly improve your symptoms.

In addition to exercising and changing your sleep habits, certain types of therapy may also be beneficial for some patients. This could include both group sessions and one-on-one sessions to address any potential underlying problems that may be making your symptoms worse.

Medications for Fibromyalgia

When it comes to medications, there are multiple options available, and occasionally, combinations may be necessary.  Many of the medications used for fibromyalgia can also be used to treat other things, such as depression, seizures, muscle spasms, and more.  Your doctor may prescribe one or more of the following medications to help control your symptoms:

It is important to keep in mind that with fibromyalgia, there is no miracle cure.  Some people may wonder whether or not opiates or narcotics (such as oxycodone, morphine, etc,) can be used to help with their pain, but these do not have proven benefit with fibromyalgia and are generally not recommended. Trying medication after medication can become costly, especially if you need to start taking multiple medications.  By working on lifestyle changes and giving the medications a chance to work, you will be on the right track to saving money and energy as well as getting back to a normal life.

 

References

  1. https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
  2. http://www.mayoclinic.org/diseases-conditions/fibromyalgia/home/ovc-20317786
  3. Goldenberg DL. Initial treatment of fibromyalgia in adults. In: UpToDate, Schur PH (Ed), UpToDate, Waltham, MA

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

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Don't forget your meds on vacation

by Hayde Blanco, 2018 PharmD Candidate

Whether you’re heading for the ski slopes or escaping the cold in a tropical destination, medications are likely the last thing on your mind as you pack for vacation. Between booking a flight, making sure you have your passport, or packing last minute luggage, medications can be easy to forget. However, if you take medications regularly, they should be one of the first things you should be thinking about. Whether you’re just going to the next state or to another country may determine what you need to do before packing your medications.

Things to remember before leaving

Check if you can fill your medications in a different state in case you are not able to receive a refill before leaving. You might also need additional travel insurance, in case something happens when on vacation.

Medications cannot be mailed in the U.S. except under certain circumstances, so if you forget to take them, you might have to pick some up when you arrive at your destination. ​​

A few days or even weeks before leaving, make sure you will have enough medications for a little longer than your planned vacation. In case there is a delay in getting home, you will be prepared without having to worry about getting more medicine.

If you will be traveling into a different time zone, you might need to adjust when you’re taking your medications. Talk to your physician or pharmacist, if there are any medications that need be taken at the same time daily, or to check if you should change how you are taking any of your medicines.

Planes, trains, or automobiles?

If traveling by plane, make sure to take medications in a carry-on bag, in case checked luggage gets lost and so they are easy to access. All medications are allowed on a plane including insulin, inhalers, and over the counter medication. If anything needs to be refrigerated, such as insulin, remember to pack it in an insulated medicine bag or container.

Taking prescription medications internationally

If you are going into another country, some of the medications you are taking might be illegal there. If you are traveling internationally, check that your medications are not on the country’s list of illegal medications. Additionally, take them in their original containers and bring a copy of the prescription, just to stay on the safe side.

Some countries are significantly more strict than others in what medications are allowed into the country. Narcotics or medications with a higher potential for addiction tend to have more restrictions in some countries. This is particularly important to look into ahead of time as it can lead to your medications being confiscated and serious drug related charges such as drug trafficking. Check the international narcotics board if you need to take any opioids to see if they are permitted in your destination country.  Always remember to check for any medication restrictions in the country you are traveling to especially if it is somewhere you have never been before.

If you need to take an EpiPen or other similar medication for an allergic reaction, make sure it is under your name. If you are likely you get a severe allergic reaction, such as anaphylaxis, consider wearing a medical identification bracelet that includes what to do in case of an unexpected reaction.

Do you need a vaccine?

Get informed on any vaccines you might need before traveling to a certain location. It’s important to get vaccinated before traveling, because in the rare instance you would catch something, you don’t want to bring it back to the U.S. and cause a possible outbreak. To read more about getting travel vaccines, check out this previous post.

Know your medications and diagnosis

If you are traveling for an extended time, ask your doctor about a list of possible generic alternatives, as well as a prescription, and diagnoses of what you are taking your medications for. Since some areas will only fill prescriptions written in that country, they might need to write a new prescription, and the medication you are currently taking might not be an option where you are staying.

Although forgetting to pack a vitamin is usually not something to worry about, not taking a chronic medication, such as a blood thinner or a blood pressure medication, for a few days or weeks can lead to more serious consequences and potentially even a trip to the emergency department. In the excitement of planning and packing, don’t forget to pack your medications for your next vacation.

 

References:

  1. https://www.cheapflights.com/news/traveling-with-medication/
  2. https://www.osac.gov/pages/ContentReportDetails.aspx?cid=17386
  3. http://www.miusa.org/resource/tipsheet/medications
  4. http://www.medicinenet.com/script/main/art.asp?articlekey=63470
  5. https://pe.usps.com/text/pub52/pub52c4_019.htm#ep290406

Do you need to save on your prescription medications?
Visit www.WellRx.com to compare prices on medications at pharmacies near you.
Same medications. Same pharmacies. Better prices.

 

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Rhabdomyolisis can cause muscle cramps, particularly in the legs.

by Sapna S. Patel, PharmD (2017)

For many who have been diagnosed with hypercholesterolemia, commonly known as high cholesterol, changes in diet and exercise may not be enough. If your doctor has prescribed a statin medication to lower your cholesterol, you may have heard or read about the potential side effects of statin drugs and their impact on liver function.

Doctors will often prescribe statins to lower the total cholesterol and reduce the risk of a heart attack or stroke in people with high cholesterol levels. While statins are highly effective, they have been linked to muscle pain in some people, and in rare cases, even cause liver damage.

So what is rhabdomyolysis?Coca-Cola colored urine caused by rhabdomyolysis

Rhabdomyolysis is a severe, debilitating muscle pain (interferes with your ability to perform normal daily tasks) due to muscle damage and breakdown. This causes your damaged muscle to release their proteins into your bloodstream, become eliminated through your kidneys (ultimately leading to your kidney(s) shutting down), and appearing in your urine (which explains why the urine color of a patient experiencing rhabdomyolysis is referred to as “Coca-Cola” or “reddish-brown” color).

Some common statin medications are:

Statin medications can be very beneficial to your health. Statins can decrease the amount of “bad” cholesterol, which can clog your arteries, preventing oxygen-rich blood from reaching essential organs. Decreasing your “bad” cholesterol can lower your risk of having a heart attack or stroke. Ultimately, this leads to living a longer and healthier life.

The majority of Patients benefit from using statin medications if indicated by their physician. Less than 3% of patients on statins report muscle pain while less than 0.5% report rhabdomyolysis. So, don’t stop using your statin medication until your physician confirms this side effect.

Common Symptoms of Rhabdomyolysis are:

In the larger muscle groups, like your thighs, shoulders, lower back, and calves:

  • Muscle tenderness
  • Severe muscle pain
  • Muscle weakness/fatigue
  • Muscle Stiffness
  • Muscle Cramping

Other signs of rhabdomyolysis are:

  • “Coca-Cola” or “reddish-brown” urine
  • Skin changes (discoloration or blisters)

How do I know if a statin medication is causing my symptoms?

Ask your Physician for bloodwork to check for abnormal Creatinine Kinase (CK, CPK) levels, liver function, and kidney function tests. These labs are not routinely checked during bloodwork.

Symptoms of rhabdomyolysis usually occur 4-6 weeks after first starting on a statin medication. However, they can occur years after being on a statin medication, so it’s important to always be aware of the symptoms of rhabdomyolysis.

If your only symptom is muscle pain, think about other reasons why your muscles may be painful, sore, stiff, or crampy. Could it be due to unusual physical activity such as hiking up a new trail, shoveling the driveway after a massive snowstorm, or trying a vigorous exercise routine, like spin cycling or high intensity interval training?

What if I do have rhabdomyolysis?

If you do end up with a diagnosis of rhabdomyolysis, your physician will likely stop your statin medication. There are statins that have a lower risk for rhabdomyolisis, such as pravastatin (Pravachol) and fluvastatin (Lescol).

As a final note, if you’re taking a statin, you should also avoid eating grapefruit or drinking grapefruit juice. Grapefruit contains compounds called furanocoumarins that stop your body’s natural enzymes from doing their job. As a result, more of the statin drug is absorbed, making it more powerful than it would normally be.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance copay!

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prescription savings app in hand - low-price map

Twitter-like App for Healthcare Professionals: Interview

by Tim Sandle, Dec 2, 2017

ScriptSave WellRx is disrupting the pharmaceutical industry by promoting price transparency with a free mobile app. Consumers rarely know what the “real” price is for their prescriptions. This now set to change and Dr. Marcus Sredzinski tells us how.

The new ScriptSave WellRx is allowing consumers in the U.S. to see the real price behind every prescription, regardless of where they live. ScriptSave WellRx is designed to provide instant savings at the pharmacy register for both brand-name and generic prescriptions.

The app is the idea of Dr. Marcus Sredzinski, who is the Chief Operating Officer at ScriptSave WellRx. Dr. Sredzinski has more than 24 years of experience in healthcare, working with the the largest insurers, health plans, pharmacies and pharmaceutical organizations across the U.S.

To discover how the app works and the benefits it can potentialy deliver, Digital Journal spoke with Dr. Sredzinski.

Digital Journal: Thanks for the interview. What are the current concerns with drug pricing?

Dr. Sredzinski: There’s simply too much confusion here, and that’s a big part of the problem. For example, in the pharmacy industry, talking about drug pricing requires more specificity; are we talking about the wholesale price, the retail price, the brand price, the generic price, the cash price, the discount price, etc.?

Of course, the patient is likely just concerned about getting the “best” price, but s/he has no solid benchmark to serve as a guide, and few people understand the intricacies. Therefore, we’re ultimately all left reading the kind of stats that grabbed headlines for Consumer Reports recently, suggesting that as many as 14 percent of Americans aren’t taking their medication because they can’t afford it.

DJ: How important is it to have greater price transparency for pharmaceuticals?

Dr. Sredzinski: The increasing presence of high-deductible and catastrophic health plans continues to put more emphasis on the need for patients to become knowledgeable consumers of healthcare. As such, it becomes essential for the industry to show up with universal price-transparency tools. That is one of the biggest visions of ScriptSave WellRx – to bring greater price transparency for all prescription drugs.

Traditional health plans utilize copays as a tool for members to pay for prescription drugs. Because of this, many patients have been blind to the actual cost of their meds. That’s simply not today’s reality and, now that the blinders are off, many patients are shocked at what they’re faced with.

DJ: How will the ScriptSave WellRx app work?

Dr. Sredzinski: It’s so much more than just a pricing and discount tool. Sure, that’s where it started – allowing patients to understand what it would cost to pay cash for their prescription and to get a discount relative to that cash price. However, we want people to realize that this as an adherence and persistence tool as well.

Not only does the app provide prescription price transparency, it also allows patients to set alerts for when they’re due to take their next pill, as well as when it’s time to order their next refill from the pharmacy. We’ve also built in functionality to help keep track of side-effects that the patient might want to share with their doctor. It really has come a long way from the early days of just providing discounts to those without insurance.

DJ: Where do you collect the data for the app from?

Dr. Sredzinski: We have some extremely long-standing and trusted relationships with pharmacies, many of whom we view as true partners in our endeavors. The data that we are privy to come from these pharmacy partners.

DJ: How often is the data updated?

Dr. Sredzinski: We have a team of pricing analysts who work on these data every single day. In fact, that’s all they do – day-in, day-out. Prescription pricing really can be that changeable and complex, which is why we encourage our members and patients all over to be regularly checking in with the ScriptSave WellRx app or website ahead of every refill – the data are updated every single day.

DJ: What has the response been from the pharmacy profession?

Dr. Sredzinski: We’ve spent the past 20 plus years working extremely closely with retail pharmacy networks and we’ve always been about more than just providing a discount. The focus is on the continuum of care and, as such, the responses we’ve attracted have generally reflected a visionary status among our partners over time.

From the pioneering efforts of some pharmacies who had us help with the building and running of their in-store pharmacy loyalty programs, to a new pharmacy MTM partnership with Sinfonia Healthcare Group, it’s always been a humbling experience to roll out new innovations in such collaborative ways.

DJ: How have consumers reacted?

Dr. Sredzinski: Every time I look at our Facebook page I’m blown away by the positive sentiment that folks seem to want to share with their family, friends, neighbors, etc. The world has truly become a digitally social place, and health-and-wellness related products like ours are no exception to the “Like” button. When we unveiled the new Medicine Chest feature, that one certainly got consumers’ attention, as did the free “Ask A Pharmacist” MTM program with Sinfonia.

DJ: What has the up-take been like?

Dr. Sredzinski: Way beyond expectations, and it’s not solely from the consumer and patient sector. We’ve been inundated by inquiries that run the gamut from health-and-tech entrepreneurs with ideas on possible evolutions, to insurance and pharmacy pioneers wanting to discuss potential opportunities to work more closely together.

Meanwhile, we have prescribing physicians telling us that we’re literally helping them to save patient lives by allowing them to hand out our savings card free with every prescription they write.

DJ: Where can the app be obtained from?

Dr. Sredzinski: It’s currently available for iPhone and Android, and there are links on the WellRx website to our listings in each of those app stores.

DJ: What other types of healthcare related technology interest you?

Dr. Sredzinski: Personalization and machine-learning are going to be part-and-parcel of how healthcare will be paid for in the future. Hyper-personalization is the key, and we’re taking this seriously. I recently co-authored a white paper on this topic with Gary Hawkins, the Founder & CEO of the Center for Advancing Retail and Technology (CART). The paper focuses on the massive disconnect between the healthcare, retail and grocery industries, as well as the roll big-data have to play in this regard.

Imagine allowing a patient with diabetes or high cholesterol to seamlessly share this information with local grocery stores and Consumer Product Goods (CPG) manufacturers. The next time this patient restocks the pantry, their personalized offers could easily reflect foods that have been certified by the American Diabetes Association or the American Heart Association.

DJ: What other projects are you working on?

Dr. Sredzinski: We have a couple of big ones in focus at the moment. The first is to take a new look at an older concept we helped pioneer way back in our early days as a young company. The market for pharmaceutical copay cards is ripe for evolution and that’s right in our wheelhouse, so we’ll be working with interested pharma manufacturers to help change the dynamic in this space. In tandem with that, as anyone who attended the National Association of Chain Drug Stores’ annual expo in August will know, our innovation in the personalized wellness space won industry recognition as we’re building a product to help connect retail pharmacy, retail grocery and consumer healthcare.

The project sees us working closely with some of the most innovative retail pharmacies and front-of-store retailers in the industry, and we’re bringing healthy offerings from the CPG space then syncing them to personal wellness profiles that patients can maintain within the ScriptSave WellRx platform.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

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Pharmacogenomics pharmacogenetics image

by Leah Samera, PharmD Candidate, Class of 2018

As with most things, when it comes selecting a drug regimen for the treatment of chronic disease, one size does not fit all. If you take medications, you may have wondered why that is the case. One reason is because of pharmacogenomics.

Pharmacogenomics refers to “the entire spectrum of genes that interact to determine drug efficacy and safety.” In practice, many people may use the terms pharmacogenomics and pharmacogenetics interchangeably.

Pharmacogenetics, however, also refers to variants of one gene that affect drug response. The study of both pharmacogenomics and pharmacogenetics can help to optimize drug therapy and minimize drug toxicity based on an individual’s genetic profile.

What is a gene?

A gene is a series of codons that specify a particular protein. Genetic variation may result in altered protein sequence and function or in altered protein levels. This is significant, because these proteins can have an effect on how your body interacts with medications.

How do pharmacogenomic variations affect drug response?

The impact of pharmacogenomic variations on drug response have traditionally been divided into four categories:

  1. Those that affect drug pharmacokinetics. Pharmacokinetics refers to how a medication moves through a person’s body, i.e., how the drug is absorbed, distributed, metabolized, and eliminated.  An example of a genetic variation that affects pharmacokinetics is one in which drug metabolism is altered, subsequently affecting plasma concentration.
  2. Those that effect on pharmacodynamics. Pharmacodynamics refers to a person’s therapeutic response to a medication; this depends on a medication’s affinity and activity at its site of action. An example of a genetic variation that affects pharmacodynamics is one in which binding of a drug to its receptor is reduced, thereby decreasing therapeutic efficacy.
  3. Those that affect idiosyncratic reactions. An idiosyncratic reaction is an adverse reaction to a medication that is both rare and unpredictable. An example of a genetic variation that affects idiosyncratic reactions is one in which the likelihood of a hypersensitivity reaction to a certain drug is increased.
  4. Those that affect disease pathogenesis or severity and response to specific therapies. Pathogenesis refers to the origination and development of a disease. An example of a genetic variation that affects pathogenesis is a specific molecular defect related to the development of certain malignancies for which there are targeted therapies.

How can the study of pharmacogenomics help to optimize your drug therapy and minimize side effects?

Organizations like 23andMe allow people to “access, understand, and benefit” from the study of pharmacogenomics. With their simple home-based saliva collection kits, all you have to do is order their Health + Ancestry service; register, and spit into, the provided tube; and mail the kit back to their lab via the pre-paid package. Next, their lab extracts, processes, and analyzes the DNA from the cells in your saliva. Within 6 to 8 weeks, you get an email notifying you that you can view your results in your online account and discover what your DNA says about you. By sharing those results with your healthcare providers, they then can use that information to ensure that you get the most benefit from your medications while minimizing the risk of side effects.

References:

  1. Cavallari LH, Lam Y. Pharmacogenetics. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey L. eds. Pharmacotherapy: A Pathophysiologic Approach, 10e New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com.ezproxy4.library.arizona.edu/content.aspx?bookid=1861&sectionid=146077703. Accessed September 12, 2017.
  2. Roden DM. Pharmacogenetics. In: Brunton LL, Knollmann BC, Hilal-Dandan R. eds. Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 13e New York, NY: McGraw-Hill; . http://accesspharmacy.mhmedical.com.ezproxy4.library.arizona.edu/content.aspx?bookid=2189&sectionid=167889559. Accessed September 12, 2017.
  3. Tantisira K, Weiss ST. Overview of pharmacogenomics. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 13, 2017.
  4. Our Mission. 23andMe.com. https://mediacenter.23andme.com. Accessed September 13, 2017.
  5. How it works. 23andMe.com. https://www.23andme.com/howitworks. Accessed September 13, 2017.
  6. Our science. 23andMe.com. https://www.23andme.com/genetic-science. Accessed September 13, 2017.

ScriptSave WellRx Prescription Savings & Wellness News

Do you need to save money on your IBS, Chronic Pain, Cholesterol or other medications?

Visit www.WellRx.com to compare prices at pharmacies near you.

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Beating high prescription costs - WJLA

by Lisa Fletcher, ABC7 News

Washington, DC (WJLA) – Millions of Americans with health insurance still pay out-of-pocket for medications. And the cost can reach hundreds or even thousands of dollars a year.

But what many drugmakers and pharmacies don’t want you to know is that you could lower your medication costs, sometimes by as much as ten-times, by simply walking across the street to a competing pharmacy.

On a recent fall morning, ABC7 News caught up with Poet Taylor, the host of a popular Washington, DC radio show. As she regaled her listeners with stories and witty banter, you wouldn’t have guessed she suffers from asthma. Her job and her well-being depend on her ability to control it.

“Asthma is a very serious, serious diagnosis,” said Taylor. “The wrong medication could result in me having an asthma attack and not being properly medicated.”

But Taylor, like millions of Americans, is in the center of a tug-of-war between insurance providers and drugmakers.

Big insurance companies threaten to take popular medications off their coverage list unless drugmakers reduce the price. It’s a multimillion dollar game of chicken and the drug companies don’t always flinch.

Taylor recalled a recent, surprising trip to her pharmacy. “I put in my normal refill. I’m feeling good. And I get a call from my pharmacy and the pharmacy is like, ‘nope, your insurance doesn’t cover that.’ Yes they do, I’ve been on it almost a year now. I know they do. They were like, ‘not anymore.’”

Taylor was forced to switch to another brand of inhaler that she and her doctor agree, doesn’t work as well for her asthma. Taylor says she feels like a pawn in the game of trying to force pharmaceutical companies to lower their costs.

“A company that would wager my life on, I don’t know what kind of extra money you get at the end of the year, it just reads loud and clear: We don’t really care about you. We care about the money that we make off of you,” said Taylor.

ABC7 News checked. If Taylor wanted the medication that works best for her she’d be out of pocket as much as $433.99 a month. We asked if that’s something she could afford.

“No,” said Taylor. “That would be the cost of my car insurance, my car payment and my phone bill.”

But what Taylor and millions of others like her didn’t know is that you can comparison shop for drugs just like you would a car, a bed, or the paper towels in your kitchen.

“The crazy thing we see every day is that same drug, same exact prescription, different pharmacy, much better price,” says Shawn Ohri. Ohri works for ScriptSave, a pharmacy benefits manager, or PBM.

There are about 30 PBM’s in the U.S. and they negotiate prices on prescriptions for their members.

Ohri says insured or not, everyone should comparison shop.

“Twenty-eight million people that we know are uninsured today, You’ve got 20 million people that are on high-deductible health plans in 2016 and that number’s growing year-over-year, and then you’ve got 10 to 20 percent of the people that have great coverage, but that particular drug that they’re using isn’t covered,” says Ohri.

One way to shop around is to call every pharmacy in your area. Another is to use an app.

Ohri’s company came up with an app called “WellRx.” There are a handful of others and each is likely to find different deals for you, depending on how they negotiate with the pharmaceutical companies.

Using the WellRx app, ABC7 News compiled the most popular prescriptions in DC, Maryland and Virginia and compared prices among the top 10 pharmacy retailers.

The antibiotic amoxicillin is the No. 1 most purchased drug in Maryland. It’s three and a half times more expensive at CVS than Walmart.

The high blood pressure medicine amlodipine besylate is one of the most popular prescriptions in Virginia. It’s nearly six-times more expensive at WalMart than it is at Kmart.

And in DC, the second most prescribed drug, sildenafil, used for high blood pressure in the lungs, or as a generic form of Viagra, is more than eleven-times more expensive at Walgreens than Costco…at $195.00 versus $17.60.

“It pays to shop around, even with these types of programs,” says Ohri.

And that’s something Taylor won’t soon forget as she tries to outmaneuver the insurance and drug companies.

“I’m a person who wants to live a healthy, happy life,” said Taylor. “I don’t know why you would want to stand in the way of that. And I would hope an extra thousand dollars, or extra million should not matter more than me living, me breathing, me being here.”

Remember that depending on what app you’re using, the prices can vary – sometimes by a lot.

See the original story on the WJLA website.


Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.
If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

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Anxiety medications and children photo

by Jenny Bingham, PharmD

Across the United States, the rate of antidepressant use in children is rising. It has led to prescription costs exceeding $100,000 in the four states with the highest antidepressant prescription rates for children: Colorado, Florida, Pennsylvania, and Texas.

As the number of antidepressant prescriptions rise, it’s only natural that parents will have a growing number of questions about those medications. Here’s a list of common questions other parents have had when starting pharmacotherapy for their child’s anxiety and/or depression:

How many pills will my child have to take?

The simplest answer is, it depends. Pharmacists are trained to know FDA approved indications for mental health medications. By incorporating pharmacists into the healthcare team, they can help find medications that have dual purposes and decrease the amount of pills in the regimen. Talk to your pharmacist about the medications and if there are alternatives.

How will pharmacotherapy affect my child?

Each patient responds differently to medications. Whereas some patients that are prescribed a common first-line antidepressant (fluoxetine) and tolerate it well, others may have an entirely different reaction. Certain medications can have negative side effects, including:

  • shaking
  • drowsiness
  • weight gain
  • insomnia
  • dizziness
  • dry mouth
  • blurred vision
  • bleeding, and,
  • constipation.

These side effects can be extremely detrimental to a child’s quality of life. It’s important to have open communication with your healthcare provider to ensure that side effects don’t get in the way of medication adherence, school performance, or self-esteem. Current literature provides clinicians a wide variety of information about which side effects are more prominently reported in individual cases. This database of knowledge helps further individualize therapy and avoid potential side effects.

What risks are associated with pharmacotherapy?

Parents should be aware of the potential for abuse, especially with commonly prescribed anxiety medications (ex. alprazolam) that are rated as controlled substances.

Adolescents are at an increased risk of suicidal ideation when initiating certain medications. Family members must be educated on how to monitor, identify, and report these to the provider.

One must also consider the risks of not seeking appropriate treatment, like self-medication with illicit drugs, tobacco, and alcohol. Self-medication can unfavorable effects on one’s mental and physical health.

Are there alternatives to pharmacotherapy?

If a parent decides against using medications, trained therapists can provide alternative options, if appropriate. Cognitive behavioral therapy is a common tool that incorporates education, relaxation exercises, coping skills, stress management, and assertiveness training.1

Other approaches include: interpersonal therapy, motivational interviewing, dialectical behavior therapy, supportive therapy, and family therapy. These tools can also be used in combination with medication to improve depression and anxiety. Parents should work closely with their physician to determine if this is a safe option as monotherapy.

Final Thoughts

Decisions about using medications to treat anxiety and/or depression in children must be catered specifically to the patient. It is imperative for health care providers to approach this sensitive topic as a group, including the patient and parents. Pharmacists are a great resource for optimizing medication effectiveness and reducing pill burden.

References:

  1. Beck JS. Cognitive Behavior Therapy: Basics and Beyond, 2nd ed, Guilford Press, New York 2011. p.391.

Download the free WellRx app from the iOS app store or the Google Play Store,
and get registered to take advantage of our free medication adherence tools.

If you’re struggling to afford your medications,
visit www.WellRx.com to compare the cash price at pharmacies near you.
You may find prices lower than your insurance co-pay!

 

 

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Dry eye treatment eye drops

by Kali Schweitzer, PharmD candidate 2018
University of Arizona College of Pharmacy

For many people, dry eyes may only be a minor inconvenience. But for those who experience chronic dry eye, it can be a major problem, causing extreme discomfort. Left untreated, dry eye can have long term effects on your vision as well as your quality of life.

What causes dry eyes?

Dry eye occurs when you do not produce enough tears or if you are not producing quality tears.  As a result, there is not enough lubrication for the eye, leading to the gritty, burning, and irritated feeling that is most often associated with this condition.  There are a variety of things that may cause dry eye, including:

  1. Dry climate
  2. Wind
  3. Exposure to smoke
  4. Age
  5. Gender
  6. Certain medications and medical conditions.

For some, dry eye may be unavoidable, which is when finding an effective treatment that is not too costly becomes very important. In fact, one study found that the average direct cost for a patient seeking medical care for dry eye was $738 per year, and the cost to society per patient per year was over $11,000. So, the question is, what are your options if you are one of the millions of people in the United States who suffer from this condition?

Over-the-counter treatment for dry eyes

The key to managing dry eye symptoms and avoiding spending a fortune on prescriptions is to take advantage of the various over-the-counter options available.

The most popular over-the-counter treatment for dry eye is artificial tears, which help to lubricate the eye when you do not have enough tears of your own. There are many different varieties of artificial tears in the pharmacy aisle, and the most important distinction between them is that some are preservative-free while others are not. The preservative-free options tend to be more costly, but they are better for those who have more chronic symptoms because they are less likely to irritate the eyes following frequent use.

Another option that is available without a prescription is an omega-3 fatty acid supplement, which helps to increase tear production. Depending on what your doctor determines to be the cause of your dry eyes, they may have other recommendations for you that do not require a prescription for dry eyes.

Home treatment for dry eyes

In addition to over-the-counter medications, there are a number of other things you can try to prevent and/or reduce the symptoms of dry eyes. Some suggestions include blinking regularly, wearing sunglasses outside to protect your eyes, and drinking more water. If eyelid inflammation contributes to your dry eye symptoms, you may consider gently washing your eyelids, which can be done using a mild soap. Applying a warm compress over your eyes may also provide relief.

When do you need a prescription for dry eyes?

If prescription treatment does become a necessity, your doctor will discuss the different options with you. The ones most commonly used are Restasis (cyclosporine), which reduces inflammation, and Xiidra (lifitegrast), which helps you make more, quality tears. Another option is Lacrisert (hydroxypropyl cellulose), which is inserted between the eyeball and lower eyelid and slowly dissolves to release a lubricating substance. For now, these are only available as brand name medications, therefore price may be a barrier depending on your insurance coverage.

Finding the right dry eye treatment

Whether you seldom experience dry eyes or if you have constant symptoms, finding the right treatment is crucial. Dry eye can be irritating, costly, and even life-altering if not controlled. By working with your doctor, your pharmacist, your insurance company, and even prescription savings companies like ScriptSave, you will be in a better position to control your symptoms and save some money in the process.

References:

  1. Yu J, Asche C, Fairchild C. The Economic Burden of Dry Eye Disease in the United States: A Decision Tree Analysis. 2011 April. 30(4):379-387.
  2. https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye?sso=y
  3. http://www.mayoclinic.org/diseases-conditions/dry-eyes/basics/lifestyle-home-remedies/con-20024129
  4. Micromedex

 

 

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Pharmacist help manage epilepsy drugs

by Jenny Bingham, PharmD

Choosing the correct medication to treat epilepsy is a multifaceted process. Pharmacists can have a huge impact on the patient’s therapeutic response as a valued member of the healthcare team. 1

Medications used to treat seizures are called anti-epileptic drugs. Pharmacists review reams of information to ensure medication safety and suitability. The three primary concepts involved in this evaluation include:

  1. Pharmacogenetics – the role of genetic differences on an individual’s response to a drug.
  2. Pharmacokinetics – how a drug moves through the body.
  3. Pharmacodynamics – an individual’s therapeutic response to a drug.

It is important to assess for drug interactions

When medications interact with one another it is called a drug-drug interaction. Medications can enhance the effects of another drug (agonize). They can also block the effects of another drug (antagonize).

Monitoring for kidney or liver function

Medications are either metabolized in the liver or kidneys. If an individual has impaired organ function or damage, it changes how the body responds to that drug. Some medications, like Carbamazepine and Phenytoin may have more of an impact than Gabapentin.

Medications that are metabolized in the liver have an affinity for certain enzymes:

  • If a medication induces a particular enzyme, it can increase the body’s metabolism of it. The result is decreased serum concentration levels, or decreased effects.
  • If a medication inhibits, it can decrease the body’s metabolism of it. The result is an increased serum concentration level. Individuals might experience increased side effects when this happens.

What to expect for the duration of treatment

The goals of treating seizures are:

  1. Improve the patients quality of life; and,
  2. Decrease seizure frequency.

An individual’s type of seizure and previous medical history dictate how long they must take anti-epileptic drug. Patients should only make changes to their medication as directed by their provider.

In general, there is no one size fits all approach to treating seizures. However, pharmacists can prevent medication-related issues by performing a comprehensive safety evaluation as a member of the healthcare team.

References:

  1. Koshy S. Role of pharmacists in the management of patients with epilepsy. Int J Pharm Pract. 2012 Feb; 20 (1):65-8.
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