Medicaid...why?

[Crystal11]

Hello everyone- I got a phone call today from my Mom saying that my medication would be changed some due to Medicaid issues. They are no longer paying for brand name medications unless there is no brand name available for it. So this means that my Keppra will be Levetiracetam which is the same medication but can have other non-active ingredients in it that brand name Keppra pills do not have at all. My Tegretol XR won't be changed due to the fact that Tegretol XR doesn't have a generic form. This frustrates me because I've had troubles with medication specifically Tegretol when it was Carbamazepine not working well when I was little. I hope that the Keppra generic will work somewhat close tot he same as Keppra. It's label is AB which means the FDA thinks that it will act almost the same strength as original keppra.
Anyone have this problem with generic medications not working like the brand name medications?
Anyone have any suggestions to this problem?

I am planning on getting a new neurologist in my area and had already planned on requesting Keppra XR since I take 6 Keppra a day and 3 Tegretol XR pills a day and wanted to reduce the number of pills/how often I take it.
That may be one option to keeping those two medications in the brand name form only..

Anyways- everyone take care and be safe..
-CM

 

[skillefer]

I've seen several posts with generic not working as good as brand name. Try seeing if your neuro can send an override request stating that the brand name is medically necessary.

 

[jaysmom]

we dont even have coverage....we pay everything out of our own pocket! thank God carbemazapine is cheap! it is the only one that we have had our son on so not sure if there is a difference between any generic/brand name. would love to know that though....perhaps he would respond better to brand name?

 

[LivingFruity]

There can be a significant difference between the two. I would definitely talk to the Dr. about it and see if there is a way to override this with the insurance company. Getting around the red tape of insurance companies can be so frustrating. They definitely don't look out for the best interests of the patients, that's for sure.

 

[sixpack]

As my daughter's pharm says, cardiac and anti-seizure meds can be tricky on generics. Subtle changes can make a difference. If my dr forgets to write, dispense as written, on the script, the pharm calls the doc and gets clarification. Infact, right after Keppra went generic in Nov, the doc didn't write DAW. The pharm filled it as brand and called the doc.

The pharm did say, though, that if you start off on a generic, it's better to stay on generic OR if you start on name brand, it is better to stay on it. His reasoning is is that there are subtle differences so changing back and forth between the two can cause problems. Once put on a generic, you may have to have the dosage adjusted to account for any subtle changes in the meds formulation.

 

[Belinda5000]

my neuro has to write brand necessary for medicaid.
Belinda

 

[Crazy Monkey]

I have had instances within the last year, where I have had pharmacies hand Lamotrigine to me rather then Lamictal, I have problems with Lamotrigine, I pointed this out to the pharmacy and my doctors, basically Lamotrigine is cheaper then Lamictal to the government and as I don't pay for my meds then I have to like it or lump it. So I changed pharmacies until I found one that still supplies Lamictal and I have been happy ever since, but I don't know what I will do if they change as well, I think I will have a fight on my hands to continue getting Lamictal, which is silly really, why does everything come down to money when your health is involved.

 

[sixpack]

I have had instances within the last year, where I have had pharmacies hand Lamotrigine to me rather then Lamictal, I have problems with Lamotrigine, I pointed this out to the pharmacy and my doctors, basically Lamotrigine is cheaper then Lamictal to the government and as I don't pay for my meds then I have to like it or lump it. So I changed pharmacies until I found one that still supplies Lamictal and I have been happy ever since, but I don't know what I will do if they change as well, I think I will have a fight on my hands to continue getting Lamictal, which is silly really, why does everything come down to money when your health is involved.

because insurance companies and/or the government aren't in it to help the individual. They are in it to make money---especially insurance companies. The government is in it to save money.

 

[brain]

If you have CMS (Medicare/Medicaid); your Physician
can fill out the forms and go on "override" and require
you to be on specifically brand names if you are deemed
"medically necessary" and meet the requirements of such;
the new laws have changed now.

If you qualify for "catastrophic" coverage (in other words,
if you had this program for years - "grandfathered in", then
it would be no problem; other words, you would basically
be stuck with these new laws - which can take up to
60-90 days, and can require appeals, yadda, yadda, yaddas).

Programs vary from State to State, Location to Location;
and depending on what coverage and type you have all
around and altogether; as well as the criteria you meet
and qualify for. The US Government puts you into that
classification - not the State or Medical Doctors, just to
let you know in advanced.

But if you are in just Medicaid only, then you must comply
to the State's compliance and regulations pertaining to
that matters; and that itself, also varies from State to
State, location to location. However there IS a loophole
that you can work around is via the Manufacturer, only
if your Physician feels it is warranted and deemed necessary.

It is all basically due to budget cuts and belt-tightening,
it just does not apply to people with Epilepsy - it's impacting
everyone with all types of medical conditions; so it has been
a major P.I.T.A with Medical Physicians / Specialists as a
whole that even "Excedrin and 500 gallons of Coffee" won't
cover the bases with all their patients they have to deal
with... Just try to calculate the tons of patients out there!
It's mind-boggling!

 

[Crystal11]

The only thing I know about brand name and generic meds are that generics can be made by many companies and when you go to the pharmacy you may get your same medication but by different companies each time you go (possibly). I have taken chewable generic Tegretol when I was little and the generic never worked right. I still had seizures but they were reduced as in frequency but made me tired.
I am however on Tegretol XR which there is no generic for- and then I'm going to ask my new neuro for Keppra XR which there is no generic for either- I was planning on asking for it no matter what since I take 6 pills of keppra a day and 3 pills of Tegretol XR.

 

[nana1]

I have had instances within the last year, where I have had pharmacies hand Lamotrigine to me rather then Lamictal, I have problems with Lamotrigine, I pointed this out to the pharmacy and my doctors, basically Lamotrigine is cheaper then Lamictal to the government and as I don't pay for my meds then I have to like it or lump it. So I changed pharmacies until I found one that still supplies Lamictal and I have been happy ever since, but I don't know what I will do if they change as well, I think I will have a fight on my hands to continue getting Lamictal, which is silly really, why does everything come down to money when your health is involved.

i WAS ON lAMICTAL - bRAND FORM. tHEN THE STATE CHANGED IT TO GENERIC- Lamotrigine. Well while i was takeing generic my seizures started coming alot more and lasted 10 minutes or longer each time. So my neuro asked me what med i was on brand or generic? I told him Lamotrigine. He said since the state changed it people were having troubles. So neuro had to sign me another script for Lamicatal but for the Brand ones, as it was "Medically Necessary" Yes he had to fill out forms for state, as state had to give an ok for me to get brand, since state pays for most of it.

 

[joan]

My son on lamictal since 1/2006. I was told the generic only 85% as potent as the brand name. Im not sure that its true, but thats what I was told.

joan*

 

[Crystal11]

Yes that is true- generics are leagally required to be up to 85-125% effective as the name brand medication and it varies from one company to another- so each month you don't know who you're getting the medicaion from- But i do know that Mylen is the only one i've found that is making generic keppra.. So what I'm going to do is use up my extra Keppra and hopfully by the time I run out- I will have another neuro here in TX and be able to ask for Keppra XR like I had planned.
I've been on Medicaid since age 12 or so and really never had this kinda of trouble before.

Thank you guys so much for your imput- I will remember it when i go to the doctors..
-CM

 

[brain]

Editoral from Brainy ....

One more thing about generics - while the FDA requires
the formulary primary ingredient be there, the other
non-substandard can be fluctuated; which makes the
difference. Indeed true, brand name formulary is the best
because they have all the chemical and compounds that
are made up properly, the off-brands (generics) can only
come close to the brand name.

Take Zonegran - generic - Zonisamide, do you realize
how many generics of Zonisamide are out there? It's
amazing! There are 11 generics out there, if not more
by now ...

::: smacks head :::

Generics can be both good and bad, but when you have
an overwhelming amount of generic availabilities it can
wreck havoc, which in turn, may trigger drug sensitivities,
failure of drug functioning as it is supposed to, drug resistance
or tolerance to the drug, and so forth. So there is a coin
toss here. If there are but a few generic availability then
it would not be so much of an issue, but when it comes
to a point where there is such a massive overload of
generics ... that itself can create a problem for someone
who is "drug sensitive" and/or has "drug allergies".

So it is a good idea to go over it with your Physician
regardless of what medications you are on, not necessarily
anti-epileptic drugs, it can be any prescription drugs.

I learned quite a bit from my deceased father who was
a Chief Pharmacist for many years. And it never ceases
to amaze me how they let all these generics get by with
such a great fluctuation such as this.