Friday, January 30, 2004

The doctor prescribed this drug riluzole, which is under patent and the brand name Rilutek. He also asked me to get some blood tests done. I didn't accomplish either of these things yesterday. So today I set out bright and early. I went to the lab near my house (my first time there) and they were baffled by the tests he asked for. They called the clinic. The guy at the clinic asked to talk to me. I wound up talking to this guy like some kind of interpreter between him ands the lab tech. Why? The lab tech had the same feeling, but he told me that the guy at the clinic asked to talk to me. So then the lab tech got the phone back and was told by the clinic they would call him back. I read an entire essay by David Sedaris in the New Yorker, and made some phone calls on my cell phone. Until it died. But before it died I found out that the local pharmacy will sell me 60 of these Rilutek for $951. And this is a drug that at best may mildly slow the progression of ALS. And can give you nausea and the runs, etc. But $951 for a bottle of 60. So, on a tip from the nurse at the clinic, I called the Costco pharmacy. Costco is a membership ultra-mart, but the tip is that their pharmacy has cheap drugs, and you don't have to be a member to use the pharmacy. Probably because of some federal law that the Republicans are trying right now to get rid of. Costco has the same patented, marginally-useful medicine for $831. Hopefully my insurance will cover it. I do have the primo insurance. Let me give a big shout-out now to my buddy Dan, who used to work in the accounting center of a major company, and described to me how all the executives wanted to entice the employees into the HMO plan, but they themselves all chose PPO. Dan said, "Whatever the executives pick, you should pick too." I looks like he was right. Whenever I hear some poor blighter getting a hassle, he's with an HMO. When I tell the staff at clinics that I have PPO, they smile and breathe a sigh of relief. "Way to go!" they sometimes say. Then before the cell phone died I called another local pharmacy. He put me on hold and then came back on the line.

"Wow, that's an expensive drug!"
"Yeah, I know."
"What have you been quoted?"
"That's what I'm calling you for."
"Well, I can be competitive."
"OK, what's your price?
"I'll have to order this because we don't have it in stock and I can offer a good price. What were you quoted?"
"I am not sure I appreciate the trajectory of this conversation. I am seeking a price from you."
"Well, I can't give you a price, but I can be competitive. I have to see what else you were offered."
"You need me to tell you what other prices I was quoted before you can quote me a price?"
"OK, then the price was twenty dollars."
"Well I can't match that. But I can give it to you for $1100."

OK, this is the Wild West, and I am a tough cookie, so the incident was merely ironic. But imagine if I were an elderly person, or someone depressed and axious. And this guy is trying to nick for every dime.

Not long after that call, the cell battery died, and I had to go home because I was hungry. I called the regular lab which I was familiar with and they were less confused about the script, but did have a couple of questions. I emailed the doctor at the clinic with those questions and left a voicemail for one of the nurses. Then I called the front desk. They said the doctor would be back in on Wednesday, but that he would probably check his email today. "Okay?" Maybe I was cranky, and I said: "Well, it's not really OK. But I appreciate your telling me that. Thanks."

Looks like I will be going to Costco to get this stupid pill. And maybe get my blood drawn today or tomorrow for the tests.
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