Upon visiting the allergist for an examination of seasonal allergies (that caused me to spend last year’s USAMO reacting to respiratory stress rather than writing down proofs), I was promptly diagnosed with “symptoms of mild asthma” and prescribed an excess of $400 in medicine for one month of use “to relieve breathing difficulties associated with asthma”, with a vague explanation as to what I am actually allergic to and a brief suggestion to use Claritin and other generic antihistamines. I never experienced any off-season difficulties resembling asthmatic episodes, so the expensive diagnosis struck me as a rather disproportionate treatment for a likely nonexistent ailment.
As the M.D. insisted repetitively that I use the prescribed drugs every day until the next appointment scheduled for a conveniently distant date, I could not object to the assigned chemical intrusion; my parent promptly proceeded to purchase the subscriptions from CVS while constantly complaining of the cost and glancing at me out of the corner of his eye. While I was not particularly worried about any long-term costs associated with prolonged use of these pharmaceutical products, the price tag has set off alarm bells in my head: If “mild” potential asthma costs over $5000 each person per year just from purchasing prescription drugs, the costs incurred by the more severe cases of asthma must be through the roof, likely bankrupting families with children who are unfortunately struck with the condition; (which is one-quarter of urban children as of 2005).
A little math reveals effective consumer per-gram costs for the active ingredient of the three drugs prescribed:
-Singulair (Montelukast, a specific CysLT1 antagonist): $152.99 for 30 tablets of 10mg each, or $509.97 per gram
-Maxair (Pirbuterol [inhaler], a β2-adrenergic agonist): $139.99 for 1 inhaler of 80mg total, or $1749.88 per gram
Since I highly doubt the chemicals cost more to manufacture than the uranium they use in nukes, I decided that the Draconian price tag must be due to some kind of markup that funds banquets attended by every asthma doctor and allergist in my local area, laughing at the apparent gullibility of their patients and celebrating their monopoly over respiratory medical care, all while consuming the flesh of white-collar workers from diamond forks and wiping their mouth with napkins made of hundred-trillion-dollar bills.
To be fair, the medicine do have enough doses to last one month, at least partly justifying the cost—that is, if they actually work. The first impression of brief research, however, indicates otherwise. Searching for “Singulair” in Google leads to a bunch of advertisements and disclaimers listing an impressive list of side effects, with most articles referencing the drug in less-than-impressive ways. Every pop of the tiny square tablet costs $5, yet it evidently fails to live up to its expectations and apparently causes suicide. User comments on the news article seem to reflect a 67% failure rate (8 comments indicating failure of medicine as opposed to 4 ardently advocating its use). Assuming that the pro-Singulair comments are not rigged, then there’s a 2/3 chance that you’re paying $5 a day to have panic attacks, stomach aches, nightmares, permanent rashes/inflammation, amongst other terrifying side-effects. The weasel-word laden disclaimer pamphlet that came with the medicine lists hepatitis and upper respiratory tract infection as “common” side effects of Singulair, leaving me to wonder what the point of the medicine is if it’ll cause two more ailments with worse symptoms as a side effect.
Nasonex, one teaspoon of which costs more than a white-collar worker’s entire life earnings, doesn’t do much better. Google’s auto-suggest has “nasonex side effects” as the top entry when the drug name is entered, and its average rating of 2.3 on Askapatient falls under the “not satisfied” category, with feedback generally negative and indications of “terrible, terrible” side effects spanning every other column. Stunted growth in children, hyperinflated blood pressure, loss of smell/taste, lack of any appreciable effect in relieving symptoms it supposedly cures, et cetera., the same kind of feedback you would get from contemporary snake oil vendors. Reading the customer feedback on the page is the only way to appreciate the extent to which the medicine fails; it’s simply impossible to express the epic fail in this blog entry.
The Maxair inhaler, which I will likely never use, is the only one of the list that can potentially be useful to asthma patients; its cost is still a bit on the high side, but as one of few options available to chronic asthma sufferers that apparently actually work (despite cardiovascular side effects), it’s something that will have to do for the time being.
I give my condolences to anyone unfortunate enough to be afflicted with asthma and the associated medical costs; but as long as pharmacies and manufacturers continue to be content in financially crippling their customers, you’ll be paying these exorbitant costs out of your pockets. We need to change this. Now.
-Day 0: Administration of Singulair and Nasonex as directed begins with the cessation of other antihistamine intake.
-Day 1: Symptoms considerably worsen, with frequency of coughing and other unfortunate reactions nearly quadrupling. General consensus from classmates suffering similar conditions interviewed seems to be that “Singulair doesn’t work”, with suggestions to take Claritin instead of the prescribed medicine in light of my evident distress. Parents begin to question the effectiveness of the treatment and mutter about wasting four hundred bucks.
-Day 2: Slight improvement in symptoms occur, to my surprise. An unpleasant taste does, however, linger, as well as a slight headache that may or may not be related to the drugs. Approximately 19 hours from last administration, strong symptoms of hay fever return. Administration at the correct time did not alleviate the problems.
-Day 3: Slight sleeplessness occurs. Excessive migraine and intermittent headache that resembles symptoms of elevated intracranial pressure. Strong urge to drain cerebrospinal fluid. 13 hours from the last administration, a fever rises. Degree of consciousness and memory meet a sharp decline and do not recover for about 2 hours. Intellectual capacity was significantly impacted during the period of lowered awareness, as evidenced by my inability to add two three-digit numbers correctly with paper and pen and my assertion that 591 is prime.
There is substantial loss of taste and smell.