On 6/22/06 8:20 AM, in article ctcl92ldj9ent31i5b32t7qdnca4user34@4ax.com,

Now you are talking about a field in which I do have some expertise. I see
little new in ophthalmic corrective lens design that is a significant
improvement over old ones except for cosmetic purposes. There may be much
technology in cataract implants but it is in materials and mechanics rather
than novel optics. I have not been able to get a simple quarter-wave hot AR
coating applied to a glass lens that I would prefer over a plastic lens with
coatings that flake in short order.

I think new drugs come out primarily because old patents run out or to
compete with someone else's blockbuster drug. Much of the improvement is
that of marketing. If that were not the case how can brand names still
compete with generics after the patents have expired?

Again, in my case, I am using the newer, improved, drug Xalatan. I can
afford it. After this exchange, however, I might ask my ophthalmologist for
a cheaper alternative. I do not mind using the drops twice a day.

Bill

-- Ferme le Bush

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]

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.

Correct.

On 6/21/06 6:31 PM, in article gasj92l2fei23rr1n8rqtqvj2rbv5mkigf@4ax.com,

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

[snip]

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.

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.

My "answer?"

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

Many do.

Best of luck!

Neil

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.