Walgreens just announced that they will stop taking new Medicaid patients...

[I.J. Reilly]

No disdain for attorneys. But the same malpractice attorneys should have the government dictate their fees much like what some propose the government do with physician fees.

Two of my best friends are attorneys. Ambulance chasers I do not like. They take 50% of a person's (who actually suffered the pain and suffering) award and hope for the worst every day they wake up. Sounds profitable but very distasteful in my eyes.

Just so you know, the government does set the fees for many malpractice attorneys. States often have caps on the amounts that one can receive in damages as well as caps on the percentage that an attorney can take of those awards.

However, this is pretty much exclusively done on a state by state basis. Would you prefer to see a federal solution? Whatever happened to state's rights in this fair country of ours?

[Hallelujah]

Just so you know, the government does set the fees for many malpractice attorneys. States often have caps on the amounts that one can receive in damages as well as caps on the percentage that an attorney can take of those awards.

However, this is pretty much exclusively done on a state by state basis. Would you prefer to see a federal solution? Whatever happened to state's rights in this fair country of ours?

Agree 100%. Let the states decide. But since we are now discussing a national plan, let's include the attorneys as well. Let the feds dictate how much an attorney can make (let's say 10%) of the award. What's good for the physicians is good for the malpractice attorneys. That was my point.

I actually saw a malpractice attorney hand out a business card at a funeral viewing. Those are the one's i despise.

Gotta run. Last two operations of my rotation.

[CardiacCoug]

No disdain for attorneys. But the same malpractice attorneys should have the government dictate their fees much like what some propose the government do with physician fees.

Two of my best friends are attorneys. Ambulance chasers I do not like. They take 50% of a person's (who actually suffered the pain and suffering) award and hope for the worst every day they wake up. Sounds profitable but very distasteful in my eyes.

This is an interesting critique.

I guess I'm also guilty for "hoping" people have heart attacks.

[Jarid in Cedar]

I'm not sure there is a specialty out there who is more dependent on the $4 Walmart list and I applaud them for having it. But I just have to point out--Prilosec's not on it (nor is omeprazole). It still is pretty cheap however and I can't believe how many doctors have completely fallen for the Nexium scam.

Not that this addresses your main point.

[SloanHater]

My point is valid if WalMart's Pharmacies are valued by the corporation as as profit centers, not a cost centers. They most definitely are profit centers. The three hundred or so square feet of the legally defined confines of "The Pharmacy at WalMart" is far more profitable than any other similarly sized slice of floorspace within the greater WalMart store. Total profit may be higher in other departments, but no one generates revenue as efficiently (per square foot) as in the pharmacy. And their return on sales is actually pretty darned good for the retail business...

SO SORRY, walMart doesn't view its pharmacies as sunk cost centers, but as viable profit centers. My points all stand...

As to your last question - most grocery stores view their pharmacies the same way that WalMart Does. The pharmacy makes the store a lot more money than selling day-old baked goods in the space that otherwise would have been the pharmacy. They're expensive to run - expensive personnel, regulatory hassles, etc. But even after that, they still bring in $$$. If they could improve that number enough by "divesting out of Medicaid" they all would.- unless someone could renegotiate with the state medicaid people to get a higher payout. In this environment, don't expect that to happen.

What we'll end up seeing is state drug stores, like state liquor stores here in Utah, where you go and get the stuff no one else can or will sell to you because your state insurance sucks so badly. It'll have the stigma of having your gynecologist being nice Doctor Ngyuen at the County Health Department - unless he's back to Vietnam on vacation, in which case it will either be Doctor Miles (Go Grenada!) or Doctor Iagobradovitch who supposedly tight with the Russian Mob...

The market made great strides to open all things up to all people. Obamacare is closing it right down...

lol. Great analogy.

I thought these state drug stores already existed. Just visit your local ER.

[Edit] Also, you started by arguing that Wal-mart is considering a similar action by no longer accepting new Medicaid patients, then you rant about Wal-mart pharmacies being the most profitable square foot per Wal-mart acreage. Why don't you address my point that Wal-mart spends millions on advertising to get people in their stores, why wouldn't they spend millions on drugs to get people in their stores?

[CardiacCoug]

I'm not sure there is a specialty out there who is more dependent on the $4 Walmart list and I applaud them for having it. But I just have to point out--Prilosec's not on it (nor is omeprazole). It still is pretty cheap however and I can't believe how many doctors have completely fallen for the Nexium scam.

How about the Cipro XR scam?

I've seen a few people on that recently. I guess if you were taking Cipro for months for prostatitis or something it might make sense.

I have no problem making sure that pharmaceutical companies have huge windfalls when they make true, pioneering achievements in drug development. But packaging just the active isomer or making sustained release formulations doesn't seem like it should make tens of billions for these companies.

[landpoke]

Can someone explain the "Nexium scam" for those of us who went to law school/business school/were liberal arts majors etc.?

[CardiacCoug]

Can someone explain the "Nexium scam" for those of us who went to law school/business school/were liberal arts majors etc.?

Nexium is just the active isomer of omeprazole.

Omeprazole contains a mixture of the active drug and its inactive mirror image molecule.

When Prilosec (omeprazole) was going generic, AstraZeneca heavily marketed Nexium as an expensive substitute even though it is just omeprazole without the inactive, mirror image molecule.

There is probably no medical advantage whatsoever to Nexium over generic omeprazole, but that hasn't stopped tens of millions of prescriptions from being filled for it.

[landpoke]

Gotcha, thanks. Stupid drug companies.

[RobinFinderson]

It seems strange that it is possible to patent a molecule.

[wuapinmon]

I take Nexium every day. It costs me $30 a month with insurance ($25 if I use mail-order). If I want to switch to omeprazole, what should I tell my family pract. (in case he's swallowed the Nexium Kool-Aid)?

[Jarid in Cedar]

I take Nexium every day. It costs me $30 a month with insurance ($25 if I use mail-order). If I want to switch to omeprazole, what should I tell my family pract. (in case he's swallowed the Nexium Kool-Aid)?

Check and see if prilosec(omeprazole) is cheaper.. It should be...and ask him to change it for you. You need double the mg to be equivalent; Nexium 20 mg=prilosec 40 mg

[wuapinmon]

Check and see if prilosec(omeprazole) is cheaper.. It should be...and ask him to change it for you. You need double the mg to be equivalent; Nexium 20 mg=prilosec 40 mg

Sometimes I'm in awe of all the crap that physicians have to/can memorize.