My best friend has epilepsy. He has a part D Rx plan through his medicare disability. The Dr. he see's is a specialist and does not want him to take generic brand anti epileptic drugs. He takes Lamictal and Dilantan. He is also in a drug study and the mfg. of the study drug supplies this for him. No way can he pay for the Lamictial and Dilantin and his part D drug plan will not pay for it either.
Has he explained to his Dr that wants him to take the name brand that his Part D will not cover the brand name? Sometimes the Dr can write a letter to CMS (medicare) to let them know that the brand name is medically necessary and get them to pay for it. It would be worht a try. this is not new information. Usually if a person with seizures starts taking a brand name seizure medication he should not switch to a generic. There can be up to a 10% difference between brand name and generic anticonvulsants and this difference can be enough to precipitate seizures. Especially drugs like Dilantin. Once a person is stabilized on a brand he should stay on that brand. Even PDR (physicians desk reference) mentions this so it is not a new concept to Medicare. his Dr might need to fight a bit on his behalf but he should be able to get Medicare to cover it once he writes a letter of it being medically necessary. If this has been tried to no avail then sometimes the manufacturer has a patient assisstance program that will help him get the brand names at lower cost. There are also a few other resources where he can go to get help with paying for drugs. Let me know if you would like those resources and I will list them for you.
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