I hate you, Lamisil toe fungus monster.

by Caleb Reading

A few facts:

  • The cash price on prescription Lamisil pills is around $13 per pill.
  • Most of our patients have to take one or two pills each day for six to twelve months for it to completely remove the fungus.
  • Many insurance companies won’t pay for it except in cases where a person is unable to walk on the infected foot.

In other words, somebody sees an advertisement, makes an appointment with a doctor just to ask for a specific drug some cartoon character was shilling, gets the prescription, takes it to the pharmacy, finds out insurance won’t cover it, hears the cash price, refuses to fill the prescription, then yells at me because this is somehow all my fault.  Oh, and everybody’s health insurance rises just a bit to pay for that pointless doctor’s appointment.

Most drug advertisements are for one of these three purposes:

  1. A crap shoot to find the people whose insurance covers the extremely expensive drug.  And so what if most of the people who make a doctor’s appointment — maybe paying half a week’s pay in cash to do so — can’t afford to fill the prescription?  The drug company doesn’t care; they’re fishing for the ones who have the right coverage or cash to burn.
  2. Introducing a new (and actually unique) product (this is the rarest type of commercial, because if a drug is actually unique the doctor is already writing prescriptions for it regardless of the patients’ brand stubbornness).
  3. (Here’s the most common one.)  Getting patients to demand a drug by name when cheaper drugs in the same class or exact duplicates are already available.  For example, advertising the active isomer of generic Prilosec as “the new purple pill” (Nexium) and jacking the price way up.  Doctors know that getting patients to actually comply with a therapy can be damn near impossible, but if a patient is asking for a drug by name they might actually take it when they’re supposed to.  Even if the doctor knows it’s not the best therapy, they might still write for it anyway.

Guess which of those three categories the yellow fungus monster fits in. I’ll give you a hint. It’s the same category as the ads for Humira, an injection for rheumatoid and psoriatic arthritis that costs over $1,000 per box of 4 prefilled syringes, which is covered by very few insurance plans.

The thing that really ticks me off about those ads is, there are probably a lot of cash-strapped people making expensive doctor appointments to get the drug, not realizing there isn’t a chance in hell they’ll be able to fill the prescription.