Just a short entry this evening. A little bit of a rant and rave. I’ve been trying to gain more experience with Vyvanse. So far, the patients that I have taken it have given mostly favorable reviews. Not perfect, but none of these poisons I prescribe are. Problem is . . . the insurance companies keep telling me that I can’t prescribe it.
Or more accurately . . . I can feel free to prescribe it, they just ain’t covering it.
So when a parent of a 6 year old recently asked for Vyvanse, it was not available for use.
This is the problem with virtually all new medicines that come out. The tiered approach to prescription coverage requires that you use (generally) older and (generally) cheaper medications from the same class before using the (generally) newer and (generally) more expensive medications. From one perspective I do understand this. Pharmaceutical companies are out to make the big bucks . . . and insurance companies are trying to make their bottom line look good at the same time. Sorry patients . . . you lose. So in the Vyvanse game, I have to show failure or intolerance to two older agents before Vyvanse will be approved by many of the insurance companies in my area. My experience with stimulants is that for most people, they all work the same. So do I NEED to prescribe Vyvanse??? No, I don’t. I will prescribe Adderall instead and the kid in question will probably do just fine.
But where is my opportunity for choice???
Where are my patient’s right to choose treatment for themselves???
–DH MD
