My coworker is complaining that due to a law change that went into effect 1/1/13, his anti-anxiety medication requires him to go into his doctor every 30 days to continue his prescription and that no refills are allowed without these visits. He claims that this in order to have the government control the medication more tightly and derive additional revenue from copays and blames it all on Obamacare. Obamacare bias aside, what’s the straight dope on this? Is there such a provision that went into effect 1/1?
I went to my doc a couple weeks ago, and he gave me my normal anti-anxiety med prescription with no mention of this requirement. My next visit was scheduled several months away, as usual. Either my doc is unaware of or chooses to ignore this provision, or it doesn’t exist.
The government doesn’t derive any revenue from co-payments. The only federal limitation on prescription refills is that Schedule II prescriptions can’t be refilled. The change- assuming it exists, and isn’t the result of a change in policy by his provider or insurer- is almost certainly a state law.
I realize the copay business is nonsense but I’m interested about the 30 day issue.
Where does he live? Kentucky and Florida, among others, just changed their prescription refill laws.
Would be interested to know what the med is. As above, some are controlled more tightly than others. The doctor may also have noted that he has an issue with pills getting “lost” or something and a higher number of refills being requested, so they’ve decided to only give him 30 days at a time and make him keep coming in if he insists on having that particular med.
I’m not sure what the med is. This issue came up a few weeks ago and I haven’t heard him mention it again since then but I’ll see what I can find out.
I’m not sure where he lives but based on the location of our company it’s probably DE. Possibly MD, PA, or NJ.
That sounds like the restriction on a schedule II drug. These are mostly opiates/stimulants. I don’t see any that are thought of as strictly anti-anxiety drugs.
I am not aware of any changes that would require this under Obamacare - there has been some debate around making hydrocode a schedule II drug - to make people have to get the refills in person. I believe there are some states that already do this, but would be surprised they would for schedule III-IV non-Opiates. That being said - Xanax can be pretty easily sold on the street - so maybe some states did it for this.
Or maybe your/their health plan did. The copay thing is almost certainly crap - as not sure how that benefits the government. Let’s see “we’ll make someone pay $10 to see a doctor - then we will pay that same doc another $150 or so.”
Possibly lorazepam. My daughter can only get it in 30-day allotments with no refills.
Your friend is probably right, but as others have mentioned… nothing to do with ObamaCare.
The new meme will be that any change to healthcare must be the fault of Obamacare - except for good changes. Those will the magic of the free market.
F.D.A. Likely to Add Limits on Painkillers is perhaps what you are thinking of? Has nothing to do with Obamacare, it’s a potential reclassification of certain painkillers.
Many anti-anxiety meds are addictive and have serious abuse potential. It could only be one or two things (or a combination of the two).
The prescribing physician is being extra cautious and is possibly concerned there is abuse potential here and wants to keep close tabs on the patient - better monitoring.
Or - there was recently a law changed in that particular state - having nothing whatsoever to do with “Obamacare” - which requires certain classifications of drugs to be refilled/monitored in such a way.
There is nothing in PPACA that regulates the frequency of prescription refills and/or amounts.
Another possibility: It’s a policy change on the part of the insurance company and state and federal law had nothing to do with it.
Also, there was a broadening in Medicare Part D coverage for some formerly excluded anxiety medications that went into effect on January 1st. This was part of the ACA. I could easily visualize an insurance company change in policy to take that into account. After all, why pay for a medication if Medicare will? (Even if the coworker is too young to take advantage of it).
It was my understanding that Medicare no longer covers any benzodiazepines (valium, xanax, klonopin, etc.) and that this has been the case for several years. These are really really inexpensive generic drugs, so cost can’t be an issue. Benzos are also very highly addictive, tougher to kick than heroin (some say), and highly abusable.
Since they were developed (late 1960’s or so?) they took over the tranquilizer market from barbiturates, which were involved in too many OD deaths (“Mother’s little helper”). They were thought to be very safe – at least much safer than barbs. Doctors prescribed them like they were candy M&M’s. Lots of patients got addicted.
So now, is someone saying here that the Part D rules have been changed recently to cover benzos again (even if there are strict rules about it)?
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Am I the only one that equates usage of “Obamacare” (the word) with a strong (almost radical) pro-republican bias?
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The healthcare act Obama pushed for is almost exclusively about health insurance. Jurisdiction over prescriptions belongs to the FDA, and each state’s equivalent medical authority.
Not the only one, but Obama has decided to own the term and as an Obama supporter I have no problem with having his name associated with healthcare reform.
I don’t know if benzos are all that cheap. Some have a short half life so if you have to take them a couple/few times per day, which may be well within therapeutic guidelines, that can still be a non-trivial amount for someone who needs to pull that $20 or $30 dollars from another part of their budget.
Also, it’s not always an issue of abuse. From what I’ve heard from a variety of people (although this was maybe 7-10 years ago and there are better non-narcotic options now), you gradually tolerate to them and have to increase the dose. It’s not like opiates or something that rapidly causes a profound dependence, but it does happen over a period of years for what seems to be a majority of the people who take them.
Benzos are Schedule IV drugs, I believe – I’ve known over the years plenty who have used them for medical reasons. I’ve used them myself for some really stressful (for me) situations – not plane rides exactly, but job interviews, a driving test I had to retake because of a way-long expired license, stuff like that.
I think they are Schedule IV because of low potential for abuse – hard to imagine anyone buying them on the street at a premium. What, they’ll make you tired? Even more so chased with corn liquor? Weird world.
I think my friend told me 30 1mg Xanax (Alprazolam) ran her about $30 out of pocket (might have been $20 – can’t remember), though, so I guess it does add up if you take them multiple times per day.
Really would hate to hear this is Obamacare policy – who can afford/wants to/needs to/should see their doctor once q.m. for some trivial little anxiety medication? Gotta be some insurance thing of their own initiative.
After all, governments aren’t evil, are they? Well, never mind.
This is a joke, right? The exact opposite of what you’ve said here is the truth. Benzos have a high potential for abuse and they sell-at a huge volume-on the street at a premium.
http://www.deadiversion.usdoj.gov/schedules/index.html
“Substances in this schedule have a low potential for abuse relative to substances in Schedule III.”
So, lowest abuse potential of anything scheduled besides things like Robitussin AC.
Probably because they don’t get you high. I took about 6 mg once – got a slight buzz. Mostly tired. I guess if that’s your thing. The “booze in a pill” canard is pure bullshit – you will not get “drunk” on benzos. Maybe a little buzz, maybe slight euphoria.
I have no doubt idiots on whatever streets you frequent would buy just about anything if they thought it would get them high – more likely, people buy it to come down off something else, or just for something to do.
Of course, you can develop tolerance to them, I’ve heard. I never said they weren’t addictive.
I’m sorry Valium robbed you of your dog, son, and sold your ranch to the Herrera family, I truly am.