Scatter Pills Like Rose Petals (Skipping/Bluebirds Mandatory)

I've received FANTASTIC news in the past two weeks (yes yes...I realize that I've conformed to the rules of bad bloggering--not posting regularly to my addicted audience of two)

Lamictal, the drug I use to dumb down the seizures has.....

Oh jeez...the downside of writing is that it occasionally leads to research. I did not realize that Lamictal is also used to treat bi-polar disorders. Though being bi-polar is clearly a serious condition, it also scares the hell out of me (see crazy cat lady fears). This fear may not be normal or rational. But the kid logic that immediately popped into my head was "if Lamictal treats epilepsy and bipolar could taking it mean that I could get or have both?" Does sulking count as an "acute mood episodes"? Srsly..."acute mood episodes"? I can't imagine anyone with the brain chemistry slightly off saying, "Ooo I think I'm having an acute mood episode and that's why I've thrown your car across the street a la Hulk.

Clearly, no. Let's move on.

So LAMICTAL is the brand name of an antiseizure medication called lamotrigine. In my case it does a great job of stopping the brain fibrillation without the wacked-out side effects of Dilantin. I feel like a pretty normal person on Lamictal. But if I forget a does...well I start to forget. I missed a half dose last week and spent the next three days foggy and senile.

But here's a great incentive to not get addicted to these "life saving" drugs. They are expensive.

I spent about a sixth of my monthly income on drugs--roughly $3600 per year. 99% of that was on the Lamictal. That's more than I save for retirement annually, I could buy two "Menn Quality" cars for that price, or 35 pairs of decent roller skate (and cover tax, shipping and handling).

When my health insurance* switched the coverage to the generic a few weeks ago I saw the price of my prescriptions drop to $4--a 98% savings. Haha! Don't have to choose between eating and seizing!

There's always a catch though, right? Like a lot of generic versions of drugs, they work almost like a name brand. There's something to be said for the real $900 Prada purse and the back alley bag shop products. The discussion boards at epilepsy.com talked about the adverse reactions that popped up when folks made the change. If the generic functions the same at a rate of 70% or more it is an "equivalent" and an insurance company may require filling with the generic.

Okay since there's a pretty big impact on your life when you have a seizure let's assume that it is the equivalent of getting in a car crash that only messes you up psychologically and leaves you sore for 2-3 weeks. Imagine owning an insured car where your chances of being safe from crashes were 95-100%. Then randomly your insurance company replaced your car with a safety probability of as low as 70%. A third of the time you would be "unsafe" if a crash occurred.

Got that? Right.
The Epilepsy Foundation issued a position paper that outlines the concern with replacing reliable "high safety" drugs with generics:

The Epilepsy Foundation is seriously concerned about mandatory substitution of generic antiepileptic drugs without prior approval of the patient and treating physician. Generic formulations of a number of widely used anti-epileptic drugs are available and present the opportunity to reduce costs. Some states and some institutions (including prepaid health plans) have mandated that the pharmacist fill a prescription with the least expensive available drug.

The effect on me? Well it's been a week and a half of memory issues. You know the feeling of waking and remembering snippets of a dream. Yeah...that's been the day to day. My coworkers have been getting blank looks when they ask me about projects, I've forgotten directions to places I've been plenty of times, there's lots of wandering around wondering where I set down that pair of glasses/coffee mug/brush/book/cat. Honestly, until I started writing this blog, it hadn't occurred to me that the fog was from the meds and not the hardware.

I love have affordable drugs. I'd be willing to pay between 5-7% of my income for any type of meds as long as they work so I can work. I trust my docs--they have great training and give a damn about their patients. I like having insurance, especially after NOT having insurance and consequently missing about 10 years of routine maintenance.

Given that it's an election year and we can expect lots of stumping about healthcare, think about the dilemma that law makers, normals like you and me and health care providers face.

• How much failure can we tolerate with "equivalent" generic and name brand drugs?
• What happens when they fail?
• How much can you afford to give up to pay for prescription medication (not healthcare in general, just the pills you pop)?
• How much is a sixth of your income? At what point is it drugs or food or fake Prada purses?
• How many of us lose health insurance when the rates get high?
• Who gets to make the final decision on what pills go into your mouth--you, a doctor or an insurer?

I wish I had bullet pointed answers to match the bulleted questions. In a political year...I'm stumped on this issue.

* Love having it, but there's always more to say about insurance