This oped is by Dorothy Malone-Rising, a nurse practitioner at the Diabetes Center of Lamoille Valley in Johnson.
The House of Representatives has passed their version of the Health Care Reform bill, S.88. While I believe this bill will ensure Vermonters have access to health care, there is a provision that would require the disclosure to the Attorney General’s office of samples given to doctor’s offices.
I see patients every day, instructing and ensuring appropriate medicine therapies. Diabetes is a chronic disease marked by high levels of sugar in the blood. There is no cure for diabetes. Treatment involves careful monitoring of medicines, diet, and exercise to control blood sugar and prevent symptoms.
The House of Representatives is misguided in their push to require the disclosure of medicine samples to the AG’s office. Reporting healthcare provider’s name and license number to the AG’s office, the chief law enforcement officer of the state, sends the wrong message. Doctors interpret this proposal as an insinuation that there has been a wrongful practice, and the relationships between pharmaceutical companies and doctor is improper. I disagree.
Healthcare providers’ ability to offer patients samples allows them to work together to try various prescriptions, finding the most effective medicine or combinations of medicines, without asking the patient to pay for a prescription, deductible or co-pay to find out that it isn’t effective or the side-effects are not tolerated. In today’s economy, we should appreciate help that results in cost savings.
By reporting such information, more doctors will reject samples from pharmaceutical companies. If doctors begin to refuse samples, it is possible that access to samples will become non-existent because companies may decide to remove services from Vermont, limiting our ability to easily try new medicines.
Access to coupons and vouchers allow patients to afford their prescriptions without having to choose between medicines and basic necessities. The House not only added the disclosure requirement, but also expanded the definition of “sample” to include “starter packs and coupons or other vouchers that enable an individual to receive a prescribed product free of charge or at a discounted price.” Many patients rely on these vouchers and coupons in order to afford their monthly course of therapy. Without these coupons and vouchers the health of Vermonters is at risk, potentially increasing healthcare costs overall.
I know first-hand that if I am unable to provide patients with an insulin sample and show them how to administer it, the patient is likely to leave the office and not fill their prescription. Samples play a very important part in getting our patients started on their therapy.
While I do not benefit personally, I do take satisfaction in knowing that my patients are getting the best possible medication and know how to administer it before they go out the door. It is critical to have insulin samples available, as I am certain that many of my diabetic patients would never be converted to insulin, often the preferred treatment, if the sample were not available to give the first dose here in the office.
While some believe that sample disclosure is necessary, I stand firm: it will hurt the patient. Many doctors, nurse practitioners, physician assistants and Vermonters depend on medicine samples to find the most beneficial treatments in the most cost effective manner. Access to samples in doctors’ offices plays an important part in the quality of Vermonters’ health care. For this reason I urge the Senate to eliminate the language included in the House version of S.88 that requires the disclosure of samples, including coupons and vouchers.
