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Old 07-29-2011, 12:43 PM
 
Location: West Texas
960 posts, read 1,824,181 times
Reputation: 1192

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After being diagnosed with complex partial onset seizure disorder I was perscribed and began taking Dilantin.


Two years ago my "health plan" made a change in it's policy and only generic drugs would be covered not name brand.
Both my family doctor and neurologist urged me to stay with Dilantin.
My "health plan" said they would "penalize" me if I didn't take the generic.
Which means I pay the full amount for the name brand drug.
I did go with the geneirc (phenytoin) and within a week and a half I had two seizures. Needless to say I got right back on Dilantin.

Generic drugs have a place in health care I'm sure but, it's not the answer for every medical condition.
And I will continue to pay full price for Dilantin. It helps to protect me and those around me.
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Old 07-29-2011, 01:26 PM
 
Location: Georgia, USA
21,598 posts, read 26,269,493 times
Reputation: 26660
Quote:
Originally Posted by turkeytrot View Post
After being diagnosed with complex partial onset seizure disorder I was perscribed and began taking Dilantin.


Two years ago my "health plan" made a change in it's policy and only generic drugs would be covered not name brand.
Both my family doctor and neurologist urged me to stay with Dilantin.
My "health plan" said they would "penalize" me if I didn't take the generic.
Which means I pay the full amount for the name brand drug.
I did go with the geneirc (phenytoin) and within a week and a half I had two seizures. Needless to say I got right back on Dilantin.

Generic drugs have a place in health care I'm sure but, it's not the answer for every medical condition.
And I will continue to pay full price for Dilantin. It helps to protect me and those around me.
Did your neurologist write the insurance company and ask for an exception, documenting the seizures on the generic? That may do the trick. If not, a letter to your state insurance commissioner might work wonders.

Another option is to buy Canadian!
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Old 07-30-2011, 03:28 PM
 
Location: West Texas
960 posts, read 1,824,181 times
Reputation: 1192
Quote:
Originally Posted by suzy_q2010 View Post
Did your neurologist write the insurance company and ask for an exception, documenting the seizures on the generic? That may do the trick. If not, a letter to your state insurance commissioner might work wonders.

Another option is to buy Canadian!
A letter was written by both my family Dr. and my neurologist and sent to my "health care" provider with no change.

I hadn't thought of the state insurance commissioner. I'll give that a shot.
Thanks
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Old 07-30-2011, 05:07 PM
 
9,487 posts, read 15,091,119 times
Reputation: 15507
Quote:
Originally Posted by Roselvr View Post
I think I would find a new physician if he can't write brand necessary on the script. I'll take generics on some meds but for others no. They do not work as well.

Have you tried asking the pharmacy for brand? You usually have that option; it will cost more.

If it's your prescription insurance refusing to give brand; they want you to play a game- its called send us a letter from your doctor that it's medically necessary. I went through this with pain meds- 1st they were ok with the doctor writing medically necessary on the script; then they wanted a letter. Once the letter was sent; everything was fine.

The newest thing I'm experiencing is the insurance not allowing any meds to be filled or refilled until day 30.

Also; if you can get a 3 month script for brand; mail it to your script insurance; it will be cheaper if cost is an issue. Most are forcing us to mail away.
That fill on day 30 is a pain---we've run into that as well! Especially if traveling, etc. Used to be they allowed you a2-4 day window, but not anymore.
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Old 07-31-2011, 12:18 AM
 
Location: Georgia, USA
21,598 posts, read 26,269,493 times
Reputation: 26660
Quote:
Originally Posted by turkeytrot View Post
A letter was written by both my family Dr. and my neurologist and sent to my "health care" provider with no change.

I hadn't thought of the state insurance commissioner. I'll give that a shot.
Thanks

You're welcome!

More here on generic phenytoin:

Dilantin - Is It Safe to Take the Generic Version of Dilantin

"The Epilepsy Foundation notes that many people with epilepsy can safely use generic epilepsy medications to save money, but the decision to do so should be left up to you and your doctor. Your health plan should not mandate the use of generic medications to treat epilepsy."

"According to the American Academy of Neurology, "The Food and Drug Administration has allowed for significant differences between name-brand and generic drugs. This variation can be highly problematic for patients with epilepsy. Even minor differences in the composition of generic and name-brand anticonvulsant drugs for the treatment of epilepsy can result in breakthrough seizures."

More from the Epilepsy Foundation --- and timely:

http://www.epilepsyfoundation.org/aboutepilepsy/treatment/medications/medicationswitching/loader.cfm?csModule=security/getfile&PageID=37584 (http://www.epilepsyfoundation.org/news/Epilepsy-Foundation-President-CEO-Rich-Denness-presents-remarks-to-FDA-on-medication-switching.cfm - broken link)

Include this info in the letter to the insurance commissioner and send a copy of that letter to your insurance company.

Also mention the consequences of losing control of the epilepsy, such as possible loss of driver's license.

The insurance company is definitely in the wrong here.
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Old 07-31-2011, 11:31 AM
 
Location: West Texas
960 posts, read 1,824,181 times
Reputation: 1192
Quote:
Originally Posted by suzy_q2010 View Post
You're welcome!

More here on generic phenytoin:

Dilantin - Is It Safe to Take the Generic Version of Dilantin

"The Epilepsy Foundation notes that many people with epilepsy can safely use generic epilepsy medications to save money, but the decision to do so should be left up to you and your doctor. Your health plan should not mandate the use of generic medications to treat epilepsy."

"According to the American Academy of Neurology, "The Food and Drug Administration has allowed for significant differences between name-brand and generic drugs. This variation can be highly problematic for patients with epilepsy. Even minor differences in the composition of generic and name-brand anticonvulsant drugs for the treatment of epilepsy can result in breakthrough seizures."

More from the Epilepsy Foundation --- and timely:

http://www.epilepsyfoundation.org/aboutepilepsy/treatment/medications/medicationswitching/loader.cfm?csModule=security/getfile&PageID=37584 (http://www.epilepsyfoundation.org/news/Epilepsy-Foundation-President-CEO-Rich-Denness-presents-remarks-to-FDA-on-medication-switching.cfm - broken link)

Include this info in the letter to the insurance commissioner and send a copy of that letter to your insurance company.

Also mention the consequences of losing control of the epilepsy, such as possible loss of driver's license.

The insurance company is definitely in the wrong here.
Thank you for these resourses!
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