Health – Page 37 – Mouse Print*

Updated every Monday! Subscribe to free weekly newsletter.

Spiriva – Half the Medicine Provided is Wasted

January 25, 2016January 25, 2016 by Edgar (aka MrConsumer)

This is a strange one.

Thomas A. wrote to Mouse Print* about Spiriva — an inhalation therapy drug for people with COPD (chronic obstructive pulmonary disease). The medicine comes in a metal canister that slips into an inhaler.

What caught Thomas’ attention was the net contents statement on two different inhaler boxes — the small size (for two weeks of use) and the large size (for four weeks of use).

*MOUSE PRINT:

Both contain exactly the same amount of medicine — four grams — but one canister provides 28 doses and the other 60. How could this be?

We called the company and spoke to a nurse there to try to understand how this was possible. She directed us to the patient information sheet packed in each box.

*MOUSE PRINT:

The SPIRIVA RESPIMAT cartridge for each strength has a net fill weight of 4 grams and when used with the SPIRIVA RESPIMAT inhaler, is designed to deliver the labeled number of metered actuations (60 or 28) …

It seems the company manufactures only one size of canister but sells two different inhaler mechanisms. One delivers two-weeks-worth of medicine (28 puffs) and the other four-weeks-worth (60 puffs). So basically, the two week version is overfilled, and half the medicine goes to waste.

Now, couldn’t a smart consumer who has to use this stuff on an ongoing basis just buy the two week version and use it for a month? Or if the inhalers really are different, first get a prescription for the four week size, and then subsequently refill it with a two-week canister and get four weeks of medicine out of it for half the price?

Nope. The company is not stupid.

*MOUSE PRINT:

When the labeled number of actuations (60 or 28) has been dispensed from the inhaler, the RESPIMAT locking mechanism will be engaged and no more actuations can be dispensed.

The cash price for a month’s supply of Spiriva is enough to take your breath away — about $400. The two week version is generally only available in hospitals or as a doctor’s sample.

If the company can afford to overfill the two week cartridges, that suggests the actual cost of the medicine must be minimal.

Updated every Monday! Subscribe to free weekly newsletter.

Holy Cow, How Wise is Milkwise?

December 14, 2015 by Edgar (aka MrConsumer)

Have you checked out the dairy aisle lately? There are all these newfangled milk products on the shelf, all claiming in one way or another to be better than plain old milk.

One such product in New England stores is Hood (brand) Milkwise.

It’s got one-third the sugar, almost half the calories, and 50 percent more calcium than even reduced fat milk. How did they do that… put the cows on a low fat and low carb diet?

The answer is in the fine print.

*MOUSE PRINT:

They watered it down — water is now the first ingredient — plus they added calcium and sugar. That is why it is called a “milk beverage” instead of milk. This product is reminiscent of Trop50, the “orange juice beverage” that claimed 50% fewer calories because it is basically orange juice diluted with a lot of water.

But the Milkwise label makes it seem so healthy. How can this be? The trick is that they left out one key attribute of milk in the comparison — protein. We’ve taken the liberty of filling in the blanks.

*MOUSE PRINT:

Milkwise only has one-quarter the protein of regular milk. Expressed the other way, regular milk has four times the protein of Milkwise.

Maybe it should be called Milk-not-so-wise.

Thanks to Dr. W who was driving along the highway in Saugus, Massachusetts and saw a Milkwise billboard with a mother and child. She thought the ad was suggesting that this was a healthier milk product.

Updated every Monday! Subscribe to free weekly newsletter.

A Dirty Little Health Insurance Secret

December 7, 2015 by Edgar (aka MrConsumer)

MrConsumer has probably spent in excess of 30 hours doing research to help a self-employed New York friend find a new health insurance policy since his current company is being shut down by New York state because of its financial condition.

What the Affordable Care Act has done, at a minimum, is put policies for a dozen or more companies all in one place to help make price and benefit comparisons easier.

Shopping for a “platinum” policy — where there is no deductible and lower co-pays in exchange for paying more per month upfront — has been a challenge, not so much because of price, but rather because of the limited networks of doctors and hospitals being offered.

And that’s the dirty little secret or *MOUSE PRINT of many non-group plans. They are only able to achieve relatively low monthly premiums by having very high deductibles and/or very limited networks. For my friend, we’ve overcome high deductibles by paying more per month. But we can’t overcome the limited networks of doctors.

Of the 40 or so platinum plans listed on the New York health exchange, NOT ONE OF THEM had all four of my friend’s current doctors. And don’t think this is a problem peculiar to the exchange or because of “Obamacare.” The non-group individual plans offered directly to consumers by these same insurance companies use the same limited networks. To save money, presumably they have eliminated many of the most expensive doctors and hospitals in favor of “more efficient” ones.

As an example, Health Republic, the company being forced to close by New York, offered my friend access to 28 hospitals within five miles of his zip code.

*MOUSE PRINT:

By comparison, Empire Blue Cross and Oscar, two leading providers in the area, only offer 12 or 13.

And fewer doctors accept these two plans. Well, how big are the doctor networks for each company? They can’t or won’t tell you, making excuses that the number of doctors keeps changing or that they just don’t know. How can any health insurance consumer make an informed decision if you don’t know how limited the network is that you are buying into?

Given that lack of information about the number of doctors in an insurer’s network, how can you judge the size of the provider network that accepts your insurance? In addition to the number of hospitals test, MrConsumer created the David/John/Smith/Cohen test. If the website of the health insurance company allows you to search by first name only for primary care physicians and/or specialists, choose a radius of five miles from your zip code, and enter the name “John” or “David.” Then compare the number of Johns and Davids in each of the plans you are considering. One can presume that higher numbers indicate more doctors that accept that insurance.

If you cannot search by first name, enter a common last name like “Smith” or “Cohen” and compare how many doctors with that name each plan has.

Why is the size of insurer’s provider network important? If you are referred to a specialist by your primary care doctor for a new condition, or are diagnosed with a condition best treated at a specialty hospital, you want to be able to get treatment at this preferred provider rather than having to settle potentially for someone less expert or a less well-equipped hospital. Most of these policies do not have “out-of-network” coverage.

So what plan did MrConsumer’s friend wind up with? He still hasn’t decided, but will have to give up some of his current specialists.