Limits On Newest And Best From The World Of Biomedicine

By Robert M. Goldberg, Ph.D.

Recently, I overheard a desperate young mother beg her pharmacist to call her doctor for a prescription for Diflucan for her ill daughter. Why was she begging? Because of her short-sighted health care plan. It wouldn't permit her doctor to use Diflucan, the best drug available for treating certain infections, until another, less expensive drug, was tried and failed. Left no choice, the anxious mother sought a refill of the medicine she had been using, a poor "second best." No go. The woman's care plan needed to approve that, too. So what happened? She did what any caring mother with a sick child would have done. The woman shelled out $113 for second best and left, lighter in the pocket, heavier in the heart. Although she was forced to pay big bucks, she still didn't have the reassurance that her ill child was getting the best treatment available.

The shame of it all . . .

I happened to witness a mother and child being denied the best our research labs can produce. But many barriers are being erected to cut off people of all ages, including Baby Boomers whose need for medicines will surely increase as they reach their later years. If you developed an illness, wouldn't you want to approach the pharmacy counter confident that you can get the best money can buy? Of course. But you can't be too sure. As biomedical research continues to do its part by discovering more and more medicines--answers to cancer, Parkinson's, Alzheimer's, macular degeneration and other diseases--roadblocks in the form of frustrating and perhaps dangerous policies.

For an idea of how bad things can get, all you have to do is look across the Atlantic to Great Britain. There, to contain costs, the National Health Service refused to pay for the new anti-flu drug Relenza. When a flu epidemic struck, doctors' offices and emergency rooms became swamped. Parliament had to appropriate additional funds to cover the cost. Meanwhile, hundreds died waiting for care. Some clinics needed to hire refrigerated meat trucks to keep dead bodies cold until they could be identified. To put a bad pun on it, the Brits were penny wise and pound foolish. In the end, refusing to pay for the latest medicine cost them much more than if they had gone with that medicine in the first place.

Don't wait for the same sort of disaster to strike here. You're getting older, as is the country as a whole. Demand access to the freshest fruits biomedical research has to offer. Make your wishes known to elected officials, insurers and care plans. And don't be shy about it. You have a right to the best medical care available.

Dr. Robert Goldberg is Senior Research Fellow, Program on Medical Science and Society, Ethics and Public Policy Center, Springfield, New Jersey.

In the meantime, if you've been the victim of the kind of hassle I witnessed at my pharmacy, email me at bobgoldberg@yahoo.com. We'll look at the Top Five worst drug denials and ask those involved to explain themselves in another column.