March 7, 2012

Are Physicians Correct in Not Following ADA Guidelines?

This is one article that gave me a different message than I was expecting. When I read the headline “Many Physicians Do Not Follow ADA-recommended Prescribing Guidelines,”  I actually thought this may be a good thing. However, the article did not give me any of what I was thinking.

I had hoped that the discussion may have been about starting newly diagnosed patients with type 2 on insulin to gain maximum management quickly. No, the article was about prescribing oral medications only and not the use of cheaper, generic medications, but the more expensive oral medications. When doctors force patients to use oral medications that are more expensive by $1,120 (or more) per year, this is the wrong way to proceed.

These doctors do need to be called on the carpet and asked to explain their reasons.  There is one very effective generic that these doctors were not prescribing. It is the drug metformin that is recommended as the first line of treatment by the American Diabetes Association (ADA) and another Professional Group for persons newly diagnosed with type 2 diabetes.

This study was the work of researchers from CVS Caremark, Harvard University, and Brigham and Women's Hospital. It looked at data from pharmacy claims for 254,000 patients started on diabetes medications between January 1, 2006, and December 31, 2008. You know that insurance companies will review their records to see what the doctors are prescribing and whether they should revise their formulary.

After reading this blog and the linked article, you may wish to review your medications with your doctor to determine if you are using the correct medication and not one that is overly expensive. If your doctor has you on one of the brand medications and refuses to change to a generic, you may want to have a pointed discussion with the doctor or consider a second opinion.

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