have you considered the uses of BCG ?
i also recommend aspirin and metformin for cancer treatment.
see pubmed.org
what you have not written about is that insurance companies et al are in it for the money as ISIS is in it for God.
>>> Rigshospitalet <news@meltwaterpress.com> 9/3/2012 9:27 AM >>>
 Press release |
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3rd of September 2012 |
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Tuberculosis vaccine - a new remedy for allergies and asthma in children? M Can a vaccine against tuberculosis help combat asthma and eczema in Danish children early in life? This will now be examined in a comprehensive Danish research study. From September 2012, thousands of Danish pregnant women will receive an invitation to allow their newborns to take part in a sensational trial. The tuberculosis vaccine was removed from the vaccine program in Denmark during the 1980s, however new research indicates that the vaccine can improve the health of children. Research carried out in developing countries shows that the health of infants who have been given the tuberculosis vaccine (BCG/Calmette) at birth is improved and the babies have a better survival rate than those who have not been given the vaccine. The vaccine also seems to have a preventive effect against asthma and atopic dermatitis. Results are so striking that they cannot be explained by the fact that the children did not catch tuberculosis. Therefore, researchers assess the vaccine to have a general positive effect on the immune system, which means that children are less sick, and have less atopic dermatitis, asthma and allergies. Whether this positive effect also can benefit Danish children will now be examined in a large Danish research project headed by Lone Graff Stensballe, Paediatrician from the Department of Paediatrics and Adolescent Medicine at Rigshospitalet. The research project will run for three years, starting in September 2012, where 4,300 infants and their parents will be followed through interviews, examinations, and, for 300 of the children, blood tests as well. The project will comprise five PhD courses and a research collaboration with obstetricians, paediatricians, midwives, nurses and laboratory technicians from the three hospitals taking part in the project. “We are very excited about this unique opportunity to improve the health of Danish children early in life,” says Lone Graff Stensballe. “Unfortunately, we have seen large increases in admissions, consumption of medicines, asthma, eczema and allergies among Danish children. We hope to curb these increases with the new research project.” The research project will be carried out at Rigshospitalet in collaboration with Hvidovre Hospital, Kolding Sygehus Lillebælt and the new Centre for Vitamins and Vaccines at SSI (Statens Serum Institut). For further information and interviews, please contact: Lone Graff Stensballe Head of Research Paediatrician, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Denmark Telephone: +45 6022 8092 E-mail: lone.graff.stensballe@rh.regionh.dk |
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English
It’s not easy being an educated health care consumer.
I
was reminded of this when I went to refill a prescription this month
for an asthma and allergy medication for my 9-month-old son, Holden.
The
first time I filled his prescription for Montelukast granules — the
generic version of Singulair from Merck — my insurance co-payment was
$15. A month later, the co-payment had risen to $30 (and my insurance
was paying $85.94, rather than $118.53).
Why?
My insurance coverage hadn’t changed. My son’s prescription hadn’t
changed. Our pharmacy was the same. Why was I now asked to pay twice as
much out of pocket?
I asked the CVS pharmacist. This happens all the time, she replied. Call the insurance company to find out why.
Consumers
are navigating a health care system in which they pay an increasing
share of the cost but often have insufficient information to make the
right decisions. They assume that pharmacies are charging them the right
co-payments, that insurance companies are paying the correct share. But
as health plans’ rules for prescription drugs become more complicated,
it’s harder to tell.
It
used to be that generic drugs had one common co-pay and name-brand
drugs another. But that’s not always the case anymore, as with my plan.
Some generic drugs are expensive, and consumers sometimes pay a higher
share of their cost, more akin to what they would pay for a name brand.
Pam, the first customer service agent with whom I spoke at my insurer, Oxford Health Plans,
a division of UnitedHealthcare, told me that it looked as if there was a
mistake with the refill, and that I was entitled to a $15 refund. She
gave me a tracking number and told me to call back in two to five
business days.
Dutifully,
I did so, and talked to another agent, named Mike. He told me that
there had been a mistake, but that it was with the first prescription.
The co-pay should have been $30, not $15, but as a courtesy because of
its error, the plan would not seek to recoup the money. The baby’s
prescription was on a higher-cost tier because it was for granules of
the drug, essentially a powdered version, and not for tablets, which are
in the lowest-cost tier.
But a look at Oxford’s website and at its drug list,
also known as a formulary, revealed that Montelukast is listed as a
Tier 1 drug, with the lowest cost. No distinction is made between
tablets and powder.
Insurance
plans with multiple cost tiers have become more prevalent in recent
years, as prescription drug costs have increased over all. In 2000,
nearly half of workers with private insurance had two price categories —
typically, one for generics, the other for name-brand drugs, according
to a survey by
the Henry J. Kaiser Family Foundation and the Health Research &
Educational Trust. An additional 22 percent of covered workers paid the
same price for all drugs.
By
2013, though, such arrangements had practically disappeared. More than
eight in 10 workers had private insurance plans with three or more tiers
of drug prices.
But
my co-payments may not be the same as yours. Each insurance company —
and employer — sets its own list of approved drugs and out-of-pocket
costs. Some are fixed amounts and others are percentages of a drug’s
cost, sometimes called coinsurance. Medicare prescription drug plans
also have their own rules.
Another change is that generic drugs aren’t as cheap as they used to be. An article in The New York Times in July
detailed how the cost of some generic drugs had doubled recently, as
suppliers left the market and reduced competition. Other reports have found similar patterns.
Some
insurance companies, including mine, have increased the share that
consumers pay for more expensive generic drugs, placing them on tiers
once reserved for name-brand drugs. Your health plan should have a list
on its website.
I
wasn’t satisfied with the conflicting answers about Holden’s
prescription. I could have asked to speak with a supervisor and then a
supervisor’s supervisor. Instead, I emailed the health plan’s
representatives, telling them that I was a reporter and planned to write
about this experience.
Pretty
soon I received a call from a manager and her supervisor, offering me
an apology and telling me that, based on the recordings of my
interactions with Oxford staff members, there were “opportunities for
improvement.”
They
said that Mike, the second customer service agent, was correct and that
the drug dispensed initially was coded incorrectly by Oxford’s pharmacy
benefits manager — another division of UnitedHealthcare — and should
have been classified as a higher-cost, Tier 2 drug. They also called my
son’s doctor, and he said my son could switch to the tablet version
(with the lower co-pay) and I could crush it myself. Or, they said, I
could apply for an exemption to the higher co-payment, citing the
confusion.
I’m
not sure that every consumer gets such a call from supervisors, so I
told them that I didn’t want to be treated any differently because I was
a reporter. A few days later, my request for an exemption to the higher
co-payment was denied. I was given instructions for how I could appeal.
Mary
McElrath-Jones, a UnitedHealthcare spokeswoman, said in an email:
“Although we strive for perfection when entering hundreds of NDC [drug]
codes and testing our system for accuracy, we sometimes find errors like
the one you brought to our attention. And just as we have in this
instance, we act quickly to resolve the issue and notify our members.”
Mistakes
can happen in any industry. But what I still can’t understand is why
Montelukast is listed as Tier 1 in the company’s online formulary.
Shouldn’t consumers get accurate information if they spend the time to
research a drug’s cost? The answer wasn’t exactly encouraging.
“Our
online prescription drug list (PDL) — while comprehensive — is not all
encompassing for every drug and classification for all manufacturers,”
Ms. McElrath-Jones wrote. “It is published twice per year and includes
the top 500 most commonly used drugs. It is a great first stop for our
members who wish to know if a particular drug is included in our
formulary. For a more customized pharmacy tool, Oxford and
UnitedHealthcare members can get specific drug pricing” online.
Many
consumers aren’t up for this fuss. They either throw up their hands and
pay what’s asked or turn to experts like Lorie Gardner, a registered
nurse and the chief executive of Healthlink Advocates Inc.,
a paid service that helps patients navigate the health care system.
“It’s a maze, a complete maze trying to figure out which end is up,” Ms.
Gardner said. “There are errors everywhere, unfortunately.”
If
you find yourself in such a predicament, what should you do? First, be
prepared. Sign up for an account online with your health insurance
company, review your benefits and review your claims. You’ll be amazed
by how much — and sometimes how little — your health insurer pays for
various treatments and drugs. Second, if you encounter a problem, ask
questions. While you may have to pay the bill at the pharmacy if you
want to leave with the prescription, you should follow up with your
health plan and ask to speak with a supervisor.
Finally,
if the stakes are high enough, consider a health advocate like Ms.
Gardner. Some advocacy firms are run by former health insurance
executives, who help navigate the roadblocks that their former companies
have erected.
But,
ultimately, you may well end up doing what I did: paying the higher fee
with gritted teeth and gaining a new appreciation of how confusing our
health care system really is.
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