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Re: Timolol vs Istalol

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Re: Timolol vs Istalol

Dick Adams22 Jun 2006 15:49
> I do, however, in general, tend to prescribe newer medications because
> they have advantages over older medications.

In some cases, they are deadlier until they get recalled.  

> Likewise, I tend to use more modern lens designs/coatings,
> because they have advantages over older designs.

That is what the reps tell you, right?  What else do they do
for you?  Check out:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
1649825&dopt=Abstract


> (newer drug) can bemore efficacious, requires less frequent
> dosing, less side effects, etc.  That is usually the reason new drugs
> come out, because they have advantages over old drugs.

How about expiration of patents -- what do you think that is worth?

--
Dicky

Anon E. Muss22 Jun 2006 15:20
>It is not clear to me that higher cost is an indication of better
>medication.

I never meant to imply that.

I do, however, in general, tend to prescribe newer medications because
they have advantages over older medications.  Likewise, I tend to use
more modern lens designs/coatings, because they have advantages over
older designs.

[snip]

>In my opinion, I am not medically trained, there is good reason for a
>physician to stick to prescribing old cheap and well tested drugs unless
>there is a reason not to!

Usually there are good reasons when I prescribe a newer drug versus an
older one.  It can be it more efficacious, requires less frequent
dosing, less side effects, etc.  That is usually the reason new drugs
come out, because they have advantages over old drugs.

It is certainly also true that the newest drugs tend to cost the most.

>Best is not necessarily the latest.

Correct.

Salmon Egg22 Jun 2006 05:16
On 6/21/06 6:31 PM, in article gasj92l2fei23rr1n8rqtqvj2rbv5mkigf@4ax.com,

> [snip]
>
[quoted text clipped - 10 lines]
> It is up to the patient do let the doctor know if they prefer, say,
> cost savings over a more convenient dosing schedule.

It is not clear to me that higher cost is an indication of better
medication. To mention one medication I have taken various NSAIDS over the
years. Daypro, Vioxx, and Celebrex are just three that were expensive and
useless (for me). I guess I lucked out that Vioxx and Celebrex were no good.
Not only did they not work for pain relief but they badly upset my gastric
system, the main justification for their high price. The most recent one
that was half way decent (for me) and reasonably expensive, is meloxicam. It
is available as a generic from Canada. If price were a problem for me,
naproxen is just about as good as meloxicam.

In my opinion, I am not medically trained, there is good reason for a
physician to stick to prescribing old cheap and well tested drugs unless
there is a reason not to! Best is not necessarily the latest.

Bill
-- Ferme le Bush

Anon E. Muss22 Jun 2006 01:31
[snip]

>I thank all who responded. No one mentioned the ubiquitous (sp) drug
>salesmen who are in to the the doctor every time I'm there.  I'll see
>what happens when I tell him (again) about the cost.This is a very
>well known and competent opthalmologist.

I want to make it clear I think there is absolutely nothing wrong with
a doctor prescribing the very best medication among several potential
ones.  In fact, that's what I think doctors *should* do, it is what I
would want my doctor to do, and it's what I do.

It is up to the patient do let the doctor know if they prefer, say,
cost savings over a more convenient dosing schedule.

Jim T.22 Jun 2006 00:01
>>My eye doc has recommended that I swith from Timolol to Istalol for my
>>glaucoma.
[quoted text clipped - 13 lines]
>
>Neil

I thank all who responded. No one mentioned the ubiquitous (sp) drug
salesmen who are in to the the doctor every time I'm there.
I'll see what happens when I tell him (again) about the cost.
This is a very well known and competent opthalmologist.

Neil Brooks21 Jun 2006 15:10
>My eye doc has recommended that I swith from Timolol to Istalol for my
>glaucoma.
>Problem is that in my drug plan Timolol costs me $3 foe 90 day supply,
>and Istalol is $76!!! It's not in their "preferred list".
>Is it worth it? My pressure seems to be under control, consistently
>about 18 in both eyes.

My "answer?"

Does your drug plan allow you to lobby to have drugs *added* to the
formulary??

Many do.

Best of luck!

Neil

Jim T.21 Jun 2006 14:15
My eye doc has recommended that I swith from Timolol to Istalol for my
glaucoma.
Problem is that in my drug plan Timolol costs me $3 foe 90 day supply,
and Istalol is $76!!! It's not in their "preferred list".
Is it worth it? My pressure seems to be under control, consistently
about 18 in both eyes.

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