Color Me Appalled

I think of the state of California has some of the most progressive (and craziest) laws and regulations. I also think of California as a state full of all types of people and as being inclusive and recognizing so many of its diverse constituents. I also realize that the state has had some huge health insurance gaps in the past and the majority were resolved with the Affordable Care Act.

But I am absolutely appalled by what I recently learned about state funded breast and cervical cancer treatment program. Currently the program has these limits:

• Women under 40 are not eligible for free mammograms in the program. So if a woman with no history of cancer in her 20's or 30's found a lump, she would have to pay for her mammogram out of pocket. 
• Breast cancer treatment is limited to 18 months for young women. So if you haven't finished treatment in that period of time you are out of luck.
• Does not offer treatment if a young woman has a recurrence in the same area. 

I have to figure out why this program actually exists for young women. These limitations are insane. It provides no coverage.

So the Komen foundation (doing good for once) actually introduced a bill last year to get rid of these limitations. Actually I should not be sarcastic about the Komen Foundation (for the cure) here as this is a good example of the other types of work they do - besides sticking a pink ribbon on everything. 

The bill is making its way through the government and should eventually become law. I am just stunned that it is needed in this day and age.

Pain control vs opiate management

I am a huge fan of opiates and other pain relief medications. I never used to be. I am also concerned about addiction issues. And if someone got hold of my personal (legal) stash, I would be seriously concerned. My pain meds include several with 'street value'. I would not want to be someone who unknowingly contributed to the local substance abuse problem.

There is a new invention out there for those of us with chronic pain. These are transdermal pain patches which contain varying doses of an opiate - Butrans patches. They have worked very well for me. I started a few years ago about when they first came out at 5mcg/hour and then eventually went up to 10 mcg/hour. You change the patch every seven days and in the meantime, lots of pain relief.

I know people who it has worked for, but also I know some who couldn't tolerate side effects. Like all medications, it is not for all. The best part for me is my feeble brain doesn't need to remember to take a pill to stay ahead of the majority of my pain.

But I digress. There is a real problem with opiate addiction in the US. As a result, the government has cracked down on their availability and has created databases to confirm patients aren't doctor shopping to get multiple prescriptions. This is why I can only get a month's supply of patches with each prescription. Each monthly prescription costs $105. If I could get the 3 month supply, as in the past, the price would be $105 for three months, not one.

This is an example of the problem has been created by more restrictions to the accessibility of these drugs to prevent abuse by the few. Which creates hurdles for those in pain to get the relief they need.

I'll call this progress but the advocacy groups, the regulators, doctors, and the pharmaceutical manufacturers need to continue to work together to help curb the abusers while allowing those in need to get the treatment they require.

The FDA isn't always the bad guy.

We like to think of all the alphabet government agencies as the bad guys. They are the big brother that is overlooking everything we do, think, eat, wear, breathe, etc. But maybe this time the FDA is not the bad guy.

There is a massive problem with shortages of oncology and anesthesiology drugs in the US. Most of them are related to manufacturing problems when they are shut down for failed FDA inspections. Others have tried to claim that the FDA doesn't concern themselves with potential shortages when they cite manufacturers but that is not the case. The FDA tries to work with the manufacturers to prevent shortages and tries to get substitute drugs that are manufactured to US specifications overseas.

So where does the problem lie? In an aging manufacturing infrastructure. Hmmm.... so the same people that charge upwards of $10K per dose cant keep their manufacturing facilities up to par? I fail to sympathize here. They are supposed to be saving lives not killing people with defective drugs.