March 8, 2006

Driving for Drugs

When I wrote about my upcoming trip to Africa, I neglected to mention that part of the preparation for the trip required me to scavenge for medications like a common criminal. It also caused me to think even more about the financial incentives and disincentives of our health care system than I usually do.

Because of my complicated medical history, I take more pills on a daily basis than most people my age. If I invited you to my house for a cocktail party and you asked to use the bathroom and then snooped in my cabinets, you’d surely conclude that I am either consistently high on drugs or turning a small profit as the neighborhood dealer.

When I was packing for the safari, I checked to see whether I had enough medicine to last me through the end of the trip. It was immediately apparent that I did not. Most of the prescriptions that I take daily would run out while I am out of the country.

I laid out all my medicines and counted them up carefully. I had enough Topamax, which I take each day to prevent migraines, for nine more days; I needed enough to get me
to the end of March. As for the triptans, the medicines I take if the Topamax fails, I had four Axert, two Relpax and three Frova. It wasn’t going to be enough. Traveling tends to make my headaches worse.

My birth control pills would also run out a few days before we returned. It’s never good to mess with your cycle and risk getting crotchety.
Consequently, I did what any self-respecting drug user would do. I dropped off the kids at school and headed off in my minivan to start the Tour des Hospitals to beg samples from my doctors.

I hit gold at my OB/GYN’s. Not only did he give me a month’s supply of birth control pills, he also gave me some Ambien so I could sleep on the plane.

I drove to a different hospital to my neurologist’s office to see whether I could score some Topamax. While I did get a sample bottle of 24, they were out of triptans. I asked for and received a new prescription for my favorite triptan, Axert, but I left the office glum. The last time I filled the prescription, I almost keeled over in the aisle of CVS. My co-pay for nine pills was $75.00. I’ll do the math for you: that’s $8.33 per pill. I could go
to a bar and get a gin and tonic for that amount of money. It might work as well as the Axert and would surely be more fun.

I was highly depressed that I couldn’t get any Axert samples from my doctor, and I began to feel a bit desperate, much like a crack addict must when he sees his supply is getting low. So when I was in the elevator going to the parking garage and a perky pharmacy rep pulling a rolling suitcase got on, I concluded that she must have been an angel sent from above to fill my purse with triptans. I smoothed my hair, smiled, and chatted her up.

I complimented her shoes (Donald Pliner) and asked her who did her hair. I stayed in the elevator when it reached my floor so I could ask her who she worked for and how she liked it. I walked back in the hospital with her and down the long hall to the doctors’ offices while she told me about her boyfriend and when they were going to get married. I had invested almost eleven minutes in the relationship before I discovered that she only carrried the kinds of drugs I didn’t need, for high blood pressure and stomach ulcers. I tried not to act visibly disappointed as I took her card and promised to keep in touch.

When I got back in the van, I fumed. The reason Axert is such a lovely medication is that it usually stops a migraine yet allows you to continue your daily activities. For me at least, it doesn’t affect my ability to drive or take care of the kids. If you take an Axert, however, and the migraine progresses, a painkiller such as Darvocet or Lortab is your last resort. Obviously, these are not medications to use carelessly. They can impair your ability to function or knock you right out. I usually wait until Bill is on the way home from work before I take one so I can parent the boys without being clouded by the medicine.

And here is where the financial realities of the situation are so mixed up. My co-pay for the Darvovet is only $5 for twelve tablets. That’s about $.42 per pill. It makes it mighty tempting to skip the proper step of managing the headache with a non-habitforming $8 pill and just take the narcotics. So far I haven’t done that, and right before I left I was able to get some Axert samples.

I was relieved; I didn’t want to spend the flight using the airsickness bags for their intended purpose. Instead I planned to collect them and bring them home as cheap souvenirs for the boys. They’re at the age where they think a barf bag is hilarious.