Charlotte’s Blog

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The Side Effects Physicians Don’t Talk About

You all have heard about the side effects of FDA-approved medications that make their sales pitches on your television.  First, however, you see perhaps a bleak picture of what a medical condition can represent for a patient, but once the medication is brought into the picture, everything brightens and you want to look as healthy and happy as the person on the screen.  A voice then slips in a sometimes substantial list of side effects that may be associated with the branded medication being pitched.  Research among consumers tells us that the more significant the side effects can be the more confident consumers are that the therapy will be effective.

But the side effect that is never a part of this 30 of 60 second advertisement is the bite it will take out of your wallet…although some vague promises often are made about how “if you cannot afford ___, the manufacturer may be able to help.”  With the most recent FDA approval that the last two installments of my Blog have focused on, the conversations around what one physician calls the “financial toxicity” of therapies is ramping up.  This particular physician was referencing some of the cancer treatments currently being used, treatments that had some positive potential, but had hefty price tags.

The Alzheimer’s drug’s (Aduhelm) annual sticker price is estimated to be $56,000, but that dollar amount is likely to vary widely depending on the insurance coverage of a patient.  The folks at the Centers for Medicare and Medicaid Services are looking at an annual cost of $29 billion a year for just Medicare patients.  So, even Congress is now looking at the price of this medication that was approved based on mixed reviews of its efficacy at best.

So, my takeaway for all of you who have an older loved one is to have a serious conversation with your loved one’s physician any time a new prescription is mentioned.  Do your due diligence on line to understand as best as you can the efficacy of this new drug, its potential side effects and how it stacks up against what is available currently  (recognizing the current drug likely is available generically…and cheaply).  Then ask the doctor about price…after you have researched the price yourself.  I don’t ever question the doctor’s prescriptions, but I often ask about what they know of price, of the head to head comparisons…and what they would recommend were it their older loved one.  And, in fairness, the pharma reps who call on physicians don’t talk about price if they can help it, so everyone is in the dark.  You may be surprised at how rarely they know what the price actually is.  But it’s worth asking.

Charlotte Bishop is a Caregiver Coach, an Aging Life Care Advisor, a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. 


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