Your health care dollar at work, 2

Medco is one of the largest pharmacy benefit managers (PBM) in the country. Millions of patients fill 90 day mail order prescriptions through them. In partnership with insurance companies such as Blue Cross, their database contains vast amounts of information. When you go to the doctor, use your insurance to pay for the visit and then get a prescription filled, Medco knows your provider, your name, your diagnosis and your medication.

Medications for epilepsy, which are also used to treat bipolar disorder, have recently been identified by the FDA as being associated with suicidality. In June I received a letter from Medco informing me that one of my patients had been prescribed one of these anticonvulsants. It informed me that I should be aware that he might be suicidal.

I received that letter in June. The medication was first prescribed for him the previous December.

They advertise their ability to provide this information as being good for you, as improving medical care.

Think about this: I got their letter 6 months too late to have done any good. Medco has that patient labeled in their computer database as potentially suicidal.

Medco’s CEO’s total compensation in 2008 was $13,134,243. In 2008 the annual premium for an employer health plan covering a family of four averaged nearly $12,700. His compensation would pay the annual premium for 1,034 families.

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