April 27, 2011

Pradaxa Now Covered by Medicare Part D!!

Posted in Heart disease tips, Helpful Heart Links tagged , , , , , , , , at 8:25 pm by keepyourhearthealthy

A patient having his blood pressure taken by a...

Image via Wikipedia

The new Coumadin alternative, Pradaxa, has recently become available on the Medicare Part D formulary.  Medicare recipients finally have an affordable option to Coumadin.

The first Coumadin alternative for atrial fibrillation became available late last year and Medicare patients have been anxiously waiting for it’s inclusion in the Part D formulary ever since.  With a hefty out-of-pocket cost at $250 a month, Pradaxa was much too expensive for most of the retired community.

Even though Pradaxa prevents more strokes than Coumadin, has no interactions with food (not even spinach) and requires NO monitoring (seriously, no more fingerstick checks!), many seniors could not rationalize paying $250 a month compared to Coumadin or warfarin which can cost as little as $4 per month.  Now, 6 months after Pradaxa was approved by the FDA, Medicare Part D has multiple plans which will cover the cost of this expensive new drug.  By searching the website www.medicare.gov, patients will be able to find Part D coverage and compare prices for individual plans.  The monthly drug cost is still fairly expensive (from $30 to $50 a month) but this is still significantly less than out-of-pocket cost.

Patients who plan to switch to Pradaxa should confirm with their Part D provider that the drug is covered before trying to get the prescription filled.  Here are some important tips to help make the switch:

  • Your INR needs to be 2 or less before you can start Pradaxa
  • You must take Pradaxa twice a day!
  • You CAN take Pradaxa while also taking Plavix but only if your cardiologist feels it is safe in your situation
  • Pradaxa starts working within 30 minutes to 2 hours
  • Pradaxa is generally no longer effective if you miss 2 doses
  • You cannot take Pradaxa if you are also taking Rifampin
  • Pradaxa is not currently indicated for people with mechanical heart valves (although this may be coming within the next few years)
  • The pills expire within 30 days of opening the bottle
  • The most common side effect is heartburn (GI upset)

January 13, 2011

The New Coumadin Alternative…What Do Patients Think About It?

Posted in Heart disease tips, Helpful Heart Links, Uncategorized tagged , , , , , , , , , , at 11:47 am by keepyourhearthealthy

image by Idea go

Pradaxa is certainly ideal when you look at how it compares to Coumadin on paper.

Pradaxa is a breakthrough Coumadin alternative that prevents more strokes than Coumadin, does not require fingerstick monitoring and has almost no major interactions with food or other drugs. It sounds like a dream come true for atrial fibrillation patients everywhere who despise Coumadin!

Now that Pradaxa is readily available to patients, what do they think? Is it the amazing new drug that many have expected it to be?  Some say “yes” and some say “no.”  One Pradaxa user posted their experience with the drug on a Pacemaker Club website online and stated they “love the convenience.” Others on the same website complained that it did not work out for them.

The biggest obstacles for many are just what Pradaxa’s manufacturer expected: price and heartburn.  First, many people have to get over the sticker-shock of paying $40 to $250 per month.  Then there’s the common side effect of heartburn.  20% of patients discontinue Pradaxa because it upsets their stomach.

One patient I spoke to stopped it because the heartburn and nausea were intolerable after a few days of switching to Pradaxa.  She eventually switched back to Coumadin and resumed her routine INR checks.  In my opinion she was more likely to get heartburn on the Pradaxa because she also suffers from a large hiatal hernia (a condition where part of the stomach is squeezed up through the diaphragm) which causes problems with acid reflux.  Pradaxa’s manufacturer has already launched a defensive campaign in order to help patients work through problems related to the drug.  Their website www.pradaxa.com offers a support program which includes a hotline and a savings card.  I personally registered for the support program over 2 weeks ago and have yet to receive a response.  Maybe they have a few kinks to work out?

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