Update on medication

[shellos8]

My neurologist seems adamant that he wants me on Betaseron and because my insurance won't pay for it the doctor's office has got a call into Betaseron's assistance program to try to get me help with paying for it. I haven't been able to actually speak to the doctor so I'm not sure why he's so stuck on Betaseron. Should I just trust that he's doing what he thinks is best for me?

[Redwings]

Should I just trust that he's doing what he thinks is best for me?

No! It's never a good idea to take a medication without a complete understanding of why the doctor prescribed it and chose it over other options.

All of the CRABs have about the safe efficacy, so your doctor has to have a good reason to be "adamant" about one drug. If your insurance company requires that you try a different drug first, the similar efficacies of the meds suggests that you have just as much chance of being successful at the start with one of their preferred meds as you do with Betaseron. So unless you already have a reason to believe that you won't tolerate one of the other CRABs -- and it doesn't sound like you do -- there doesn't seem to be any medical justification for your doc to have such a strong opinion.

The fact that you haven't been able to actually speak to the doctor isn't good. The fact that you even got out of his office in the first place without having thoroughly discussed all of your options and knowing why he's adamant about just one of them isn't good. Some doctors get nice "bonuses" from drug companies for prescribing their meds. Unfortunately, that becomes their motivation for preferring a drug, not what's best for the patient. When there'$ a financial incentive, it become$ much ea$ier for doctor$ to decide which drug$ are "be$t."

It would be interesting to see what would happen if you told your neuro you don't want any trouble with your insurance company and would be fine with starting with one of their approved meds (if they require that). If he actually refuses to prescribe a different med, that would cast more suspicion on his motivations.

As long as you have medical insurance, it might be a good idea to use it to get a second opinion from a different neurologist.

[shellos8]

Some doctors get nice "bonuses" from drug companies for prescribing their meds. Unfortunately, that becomes their motivation for preferring a drug, not what's best for the patient. When there'$ a financial incentive, it become$ much ea$ier for doctor$ to decide which drug$ are "be$t."

This is exactly what my concern is as well. I think I need to speak to him before agreeing to this. Thank you for your input. I think I just needed to hear it from someone else.

[rdmc]

My neuro really wanted me on Beta...but she explained why. Betaseron is the only one that's approved for SPMS, and she thought I might be headed that way. But fortunately after many years I'm still considered RRMS.

I know some doctor's have preferences, and maybe they are financial ( although they'd be in huge legal problems if that was discovered.). But I also wonder why an insurance company would only approve some of the other CRABS and not Beta...I'm sure that's a financial decision as well. They probably get a better price on the drug they want you to try in place of the Beta.

[cosake]

Betaseron has the best medical assistance program out there if you are not able to afford MS meds. My prescrip cap is $ 2,000/yr so none of the DMDs would have been covered.

We leaned towards beta because of the financial aspect, but my doctor would have been OK with beta or copaxone or rebif for me. Finances just tipped the scales to betaseron as the only viable option at the time.