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)

February 20, 2011

Cardiologists Get Updated Guidelines With Coumadin Alternatives

Posted in Heart Disease in the News, Uncategorized tagged , , , , , , , , , , at 8:11 pm by keepyourhearthealthy

photo by Ambro

An update to the US atrial fibrillation guidelines posted last week has made Pradaxa an official part of the treatment protocol.

When the American Heart Association and the American College of Cardiology published their new atrial fibrillation guidelines in December, many people were left with more questions than answers.  The updated guidelines did not include the newest drug, Pradaxa, which is the only alternative to Coumadin at this point.  At the time the guidelines were published, the American Heart Association promised they would provide an update to the guidelines to include Pradaxa soon.  As promised, the “update” to the “updated guidelines” is officially out.

What do the guidelines say then about this new Coumadin alternative? The guidelines give Pradaxa one of the highest recommendations possible (called a Class I).  They state specifically that it “is useful as an alternative to warfarin [Coumadin] for the prevention of stroke.”  However, they also say, “patients already taking warfarin [Coumadin] with excellent INR control may have little to gain by switching to dabigatran [Pradaxa].”

These new guidelines provide further assistance to cardiologists and patients who desperately needed an alternative to Coumadin.  Through the support of the American Heart Association and the American College of Cardiology, physicians can now prescribe Pradaxa more comfortably for the patients who have trouble taking Coumadin.

February 9, 2011

Important New Information For Pradaxa Patients

Posted in Heart Disease in the News, Heart disease tips tagged , , , , , , , , , , at 1:04 pm by keepyourhearthealthy

photo from Pradaxa press release

Patients who receive their Pradaxa in a bottle are under a new advisement this week.

Many heart-savvy people have heard about a unique new drug called Pradaxa.  This ground-breaking drug burst into the pharmaceutical market in record time after gaining FDA approval late last year.  Pradaxa is famously known for being unique given that it is the ONLY alternative to Coumadin (warfarin) in terms of preventing strokes for the atrial fibrillation population.

Undoubtedly, thousands of patients have already made the switch from Coumadin to Pradaxa.  What many of these patients may not realize though is that Pradaxa is unique in another important way.  Pradaxa pills sold in a bottle are considered “expired” after only 30 days. The capsules are easily effected by humidity so the manufacturer recommends using all the medication within 30 days of opening the bottle.

A 30-day expiry is very unusual given that the standard expiry for most medications is 1 year.  Some pharmacists have returned their bottles to the manufacturer and requested blister packs instead.  Blister packs are sold in Europe and keep each pill individually wrapped, thus safe from the humidity.

In case you are a new Pradaxa user, it is important that you wait until the last minute to open the bottle.  You should also avoid having more than one bottle open at a time.  If you tend to store your pills in 2 different locations (ie. one at work and one at home), you’ll need a different routine for Pradaxa. The Pradaxa bottle has a special lid which keeps the drug stable so you should avoid putting the capsules in a different bottle. The safest place for the pills is inside the manufacturer’s bottle and the pills still expire within 30 days of opening.

January 24, 2011

The Latest on Medicare Part D and Pradaxa

Posted in Heart Disease in the News, Helpful Heart Links tagged , , , , , , , , , , , at 4:01 pm by keepyourhearthealthy

image by renjith krishnan

Medicare Part D is still not paying for the new Coumadin alternative, Pradaxa, but there is hope for Medicare patients looking to make the switch.

Ever since Pradaxa became the first alternative to Coumadin approved for atrial fibrillation, Medicare patients have been eagerly awaiting the announcement of prescription coverage with Medicare Part D.  Three months have gone by and some Medicare patients have already switched despite the high out-of-pocket expense.  Since Medicare does not pay for Pradaxa, patients are spending as much as $250 per month.

According to a Pradaxa representative, only the Military and Medco are currently covering Pradaxa.  The manufacturer has recommended several options though for patients on Medicare who need financial assistance.  A Savings Card is available by signing up for the Pradaxa Support Program.  The Savings Card gives Medicare and Medicaid patients one free month of Pradaxa and continued savings throughout the year. Even patients who already have coverage under companies like Blue Cross and Blue Shield can use the Savings Card to offset a high copay.  These patients will often pay only $30 a month when using their insurance and the card.

If the Savings Card is not a good option for you because you still cannot afford the cost, the Pradaxa representative suggested applying to a third-party assistance program such as Rxhope.com.  Rxhope.com can guide you through the process of receiving Pradaxa for free.  They even have an application specifically for Medicare patients who need Pradaxa.  You can also begin a financial assistance application by calling the manufacturer Boehringer Ingelheim directly at 800-556-8317.

Rest assured, Pradaxa will eventually become approved for coverage by Medicare Part D.  The manufacturer is working diligently on the application process.  Until then, they are hoping patients will benefit greatly by using the Savings Card or signing up for financial assistance.  Check here for updates in the future!

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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December 1, 2010

Top 10 Heart Disease Tips of 2010

Posted in Heart disease tips, New Heart Studies, Uncategorized tagged , , , , , , , , at 3:52 pm by keepyourhearthealthy

image by Francesco Marino

The year 2010 has been filled with studies and new medicines that have changed the world of heart disease.  Did you catch them all?  If not, check out this list everyone with heart disease should see!

10.  Avoid eating huge meals…studies show it could give you a heart attack!

9.  If you’re going to drink alcohol, drink small amounts daily instead of binge drinking.

8.  Teach your loved ones CPR with the new American Heart Association Home CPR Kits

7.  Discuss taking fish oil supplements with your cardiologist.  It might improve heart failure in addition to raising good cholesterol.

6.  Hold off on buying non-stick pans. There has been some evidence that it raises cholesterol.

5.  Shop around for the best place to have bypass surgery by using Consumer Reports.

4.  Choose nuts instead of processed red meat when possible.  Women can cut their risk of heart disease significantly by doing this.

3.  Bundle up during the winter. More heart attacks occur when the weather is coldest.

2.  Stop taking Folic Acid supplements.  The world of cardiology has agreed there is no benefit for your heart.

1.  If you’re taking Coumadin or warfarin for atrial fibrillation, ask your doctor about switching to the new drug Pradaxa. It’ll mean no more fingerstick checks and you can eat green vegetables without worries!

November 18, 2010

Is There A New Coumadin Alternative Better Than Pradaxa?

Posted in Heart Disease in the News, New Heart Studies tagged , , , , , , , , at 2:28 am by keepyourhearthealthy

image by Salvatore Vuono

Pradaxa‘s manufacturer, Boehringer Ingelheim, had hoped to keep the cardiology buzz about their drug in the headlines this week.  Much to their chagrin, Bayer/Johnson & Johnson stole the spotlight with their new Coumadin alternative.

Over the past several days, the American Heart Association has been holding it’s Scientific Sessions for American cardiologists in Chicago.  The spotlight of cardiology news over the past month has been a new drug called Pradaxa (dabigatran).  Pradaxa is an alternative to Coumadin that was just approved by the FDA in October and is already available for special order at pharmacies in most states.  Patients with atrial fibrillation have been waiting 50 years for an option other than Coumadin in terms of stroke prevention.

On the Boehringer Ingelheim website, an article about Pradaxa had mentioned they would be presenting their large trial about Pradaxa at the American Heart Association’s Scientific Sessions in Chicago.  The news spotlight however has been stolen by a new, upcoming Coumadin alternative called Xareltorivaroxaban) which is manufactured by Bayer/Johnson & Johnson.  Xarelto has not yet been approved by the FDA but the phase 3 trials were presented at the Scientific Sessions, giving this potential new drug much more publicity than Pradaxa.  The big trial for Xarelto showed that it works just as well as Coumadin at preventing strokes in people with atrial fibrillation.  However, it will likely take at least a year before it is available as a prescription to patients.

So what is the big deal about this new Coumadin alternative called Xarelto?

  1. Xarelto only needs to be taken once a day whereas Pradaxa is twice a day
  2. Xarelto does not require fingerstick monitoring or dose adjustments (same as Pradaxa)
  3. Xarelto was tested in moderate to high risk patients and resulted in less problems with severe bleeding than Coumadin

Even though Xarelto sounds like a great option for patients who do not want to take Coumadin, we still have to look at the facts.  Right now, Pradaxa is the ONLY alternative to Coumadin that is available and FDA-approved.  Other drugs may be coming in the next few years but a better drug than Coumadin has been needed for more than 50 years!  The biggest problem with Pradaxa now is cost.  Out of pocket it is more than $6 per day and Medicare Part D is not covering it at this point. There’s no way to know when or IF Xarelto will be FDA-approved and how much it will cost.  Let’s just pray that we can work out the barriers of price soon so that everyone with atrial fibrillation can enjoy the benefits of stroke prevention without all the hassle of Coumadin.

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November 15, 2010

Another New Coumadin Alternative on the Rise

Posted in Uncategorized tagged , , , , , , , at 7:15 pm by keepyourhearthealthy

Resized image of Ritalin-SR-20mg-full.png; squ...

Image via Wikipedia

In October the FDA approved the only alternative to Coumadin thus far, Pradaxa (AKA dabigatran).  Another new alternative has just finished a round of trials and may be joining in the famed distinction of being named “Coumadin alternative.”

This latest anticoagulant drug is called Xarelto (AKA rivaroxaban) and it is manufactured by Bayer/Johnson & Johnson.  The trial which has cardiologists buzzing about this new drug is known as ROCKET-AF.  14,000 patients with atrial fibrillation in the ROCKET-AF trial have been tested with either Coumadin or Xarelto and so far the results are promising.  Xarelto has been shown to be just as effective in preventing strokes as Coumadin.  The greatest difference between this new study drug and Coumadin is that Xarelto does not require dose adjustments and monitoring.

However, unlike the newly approved Pradaxa, Xarelto has not yet been shown to work better than Coumadin for preventing strokes.  The other Coumadin alternatives are not even approved yet and it already looks like Pradaxa has an advantage over the competition.  If approved by the FDA soon, Xarelto could still easily compete by setting their prices lower than Pradaxa.  To be honest, any drug that works as well as Coumadin but without all the hassle is bound to be popular!



November 13, 2010

The Latest in Pradaxa News

Posted in Heart Disease in the News, Helpful Heart Links, New Heart Studies tagged , , , , , , , , , at 7:33 pm by keepyourhearthealthy

photo by br3akthru

It’s assumed that patients and cardiologists alike will love the new Coumadin alternative, Pradaxa.  On Monday, we’ll get to hear more about the drug and cardiologists’ reactions to it.

The American Heart Association‘s Scientific Sessions will surely be buzzing during their presentations about the latest treatments for anticoagulation.  The scientists who tested Pradaxa on 18,000 patients in the RE-LY study are reportedly presenting their findings to the thousands of cardiologists at this large conference in Chicago (reported by The Sacramento Bee).

It should be interesting to see what the conference attendees have to say about Pradaxa at the end of the Session.  Currently it doesn’t appear that there has been a huge surge of prescriptions for this only alternative to Coumadin.  It could be that cardiologists are just not completely comfortable switching their patients yet.  Once the trend catches on though, Pradaxa could easily become the most popular drug of 2011.

Read more about Pradaxa in Yes, Your Pharmacy Can Now Give You An Alternative To Coumadin! Pradaxa is HERE!

To learn more about atrial fibrillation and heart disease, check out the book What To Do When You Have Heart Disease.

November 7, 2010

Tired of Coumadin? Ask Your Doctor About Pradaxa

Posted in Heart Disease in the News tagged , , , , , , at 2:15 am by keepyourhearthealthy

Atrial fibrillation

Image via Wikipedia

Between the fingertsicks, frequent dose changes and interactions with food and drugs, its no wonder people want to throw Coumadin out with the garbage!  Unfortunately, Coumadin has been the best option for preventing stroke in atrial fibrillation for 50 years now.

A new drug called Pradaxa (dabigatran) is now leading the way to ridding the world of Coumadin.  Pradaxa works just as well as Coumadin but does not require frequent bloodwork or changes to doseages.  As of last week, patients all over the US could start taking Pradaxa 150mg twice daily instead of Coumadin.  If you obtain a 90-day supply, the cost is about $250 per month out of pocket or $40 per month with prescription coverage.

Pradaxa has merely opened the gates for a whole new group of anticoagulant drugs.  Other options are on the way, which means more competition and cheaper prices.  For now, Pradaxa has taken the spotlight in this history-changing point of heart care.

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