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For safety and other reasons, however, federal law prohibits the dispensing of certain drugs (including finasteride, in either of its dosage levels) without a prescription. . Recognizing the tremendous cost savings to patients, many doctors have prescribed 5 mg Proscar (see,. G., here, here and here ) to patients with alopecia, who then can easily cut the 5 mg pill into quarters (the extra quarter of a milligram per day has no clinical significance). Most states statutorily allow (or even require) pharmacists to substitute cheaper generic medicines where physicians write a prescription for a branded drug, unless the doctor specifically instructs otherwise. . Different drugs, however, cannot be substituted, and under federal law different dosages of the identical chemical substance are considered, with some amount of legal fiction, to be different drugs (. So in this case, the substitution of branded 1mg finasteride (Propecia) with generic 5mg finasteride cannot come from the pharmacist alone. .5 mg version of the identical chemical substance was available. At an eye-popping 240 for a 4 month supply at some pharmacies, however, Propecia is 27 times the price of Wal*Marts generic version of Proscar, at 9 for an equivalent supply. Normally, savvy consumers facing the choice between two essentially identical products are free to buy the less expensive option. .
Wal*Marts list, this means there is no longer a need for hooggevoelig 10 co-pays or snowy treks to the pharmacy in 15 degree weather. . Thats right: the wal*Mart total price is less than most insurance company co-pays. . Finally, a major industry player seems to have put effective downward pressure on prescription drug prices. The case of Finasteride, despite this cost-effective, convenient solution, there is at least one drug for which there is a hitch. And this time wal*Mart is not to blame. . One of the drugs on Wal*Marts list is finasteride, used to treat androgenetic alopecia (male pattern hair loss which can be obtained for a bargain price of 9 at Wal*Mart (or at Target, which has a nearly identical program ). . However, patients in one major health care system (which will be referred to as Big hmo) will not have access to the wal*Mart price, and may have to pay up to 240 dollars for an equivalent supply. This unexpected state of affairs can be explained by the complex interplay between drug industry tactics, shampoo state and federal laws, insurance company reimbursement policies, and Big hmos prescription policies. Industry tactics, in the 1980s, the drug giant Merck was studying a chemical substance called finasteride for the treatment of benign prostatic hyperplasia, or enlarged prostate, when it observed a serendipitous side effect: the drug caused some study participants to grow hair. . In light of Upjohns then-recent success with Rogaine in carving out a 143 million per year market for the treatment of baldness, merck seized the opportunity. . After securing fda approval for a 5 mg version of finasteride for the treatment of enlarged prostate (branded as Proscar merck obtained separate fda approval for a 1 mg version as a baldness treatment, calling it Propecia.
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Darrow, an earlier post discussed the what equivocal efficacy of Propecia (finasteride) as a baldness remedy, ending with the provocative assertion that, efficacy aside, there is little reason for anyone ever to buy or consume Propecia (finasteride or any doctor ever to prescribe it, since. This post continues the discussion, addressing one small component of the rising cost of healthcare—the cost of finasteride. It explores why consumers pay as much as 240 for a bottle of Propecia (finasteride) when a 9 bottle of an equivalent, fda-approved supply of the identical chemical is readily and legally available at nearby stores. In the exorbitantly priced landscape of prescription drugs, there is at least one low-cost oasis: Wal*Mart. . Though some find reason to criticize the discount store, few would disapprove of the dozens of prescription medications Wal*Mart offers for an unbeatable 4 for a 30-day supply. . Cost-sensitive consumers can purchase everything from blood thinners to antidepressants to antibiotics at this price, while a 90-day supply is only 10 (and this price includes shipping to your doorstep). . A handful of drugs that cannot be sold at 4 per month sell for a still-modest. . For the 300 or so drugs.
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Episode 1, wired for sound: Music and the Brain right here: In amsterdam 2009, Episode 1 of The nerve was Shortlisted for the. Prix Italia in the work on Music category. The nerve as a series was awarded two silver Medals at the 2009 New York festivals of Radio programming in the culture the Arts and Best Editing categories.
It has a starring role on every stage of the great human drama whether we are at war or at prayer, by ourselves or with others, happy or sad music is there. But does it really have a purpose? Where does it come from? And why does it have such power over our hearts and minds? The nerve asks those questions, featuring the voices selsun and thoughts of top musicians and thinkers, from. Zakir Hussain to, howard Shore to, richard Dawkins and more. Episodes 1 and 2 aired last weekend but you can listen.
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A few years ago, chris Brookes, jowi taylor and I produced a six-part series for. Cbc radio called, the nerve: Music and the human Experience. It was a follow-up to our peabody-Award-winning series. The wire: The Impact of Electricity on Music, and it takes a look at how music is a facet of every part of our lives, from human evolution, to war and peace, to religion and personal identity. This month, radio new zealand National is rebroadcasting The nerve in its entirety, on Saturdays and Sundays at 2pm New zealand time. (Thats 5pm Pacific time and 8pm Eastern time in North America on Fridays and Saturdays.) you can listen at those times. Music is found in every culture worldwide. Its our constant draagtijd companion, from birth through childhood, love, marriage and death.