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Incompetence in pharmacare has to stop

Letter to the Editor

To the Editor,

It is very upsetting to read about the Oxford senior who cannot have his prescription of Xarelto covered by the Nova Scotia Pharmacare program.

It was prescribed to him by an internal medicine specialist. His family doctor wrote two letters to the Pharmacare program explaining that Xarelto was necessary for this patient and a better solution than warfarin.

What can be a possible reason for such a situation, that a unique criterion has to be met before a person qualifies to have Xarelto covered? Is it a shortage of this drug? Not likely! Is it more expensive than warfarin? Yes. How much more expensive? Is the extra cost less or equivalent to the cost of the blood tests that accompany the taking of warfarin? There are no blood tests required for Xarelto.

Both are blood thinners, but warfarin (also used in rat poison) can have dangerous side effects and therefore weekly blood tests at a hospital are required.

I don't know what it costs to have a blood test. I do know it involves several staff persons at the hospital, some of them with trained specialties as well as reporting to the patient's physician. My guess is that 52 such tests at the hospital, not even taking into account the patients cost of travel and parking, cost a great deal more than the extra cost associated with the drug.

Unfortunately, I have to say "my guess." Why? About three years ago, I had occasion to write to the Nova Scotia Health Authority on this subject. At the time the NSHA engaged in a media campaign wanting input from Nova Scotians. Their slogan went something like this: "We want to hear from you. How are you we doing?"

They are not doing that anymore. It seems they fully know what Nova Scotians think.

In my letter I asked them to look at the cost of the weekly warfarin tests and compare that to the extra cost of Xarelto. I never received an answer.

I can only conclude that Mr. Millard of Oxford (and many others) are caught up in one of those bureaucratic nightmares, where the left hand does not know (or is deliberately blind to) what the right hand is doing. Two government agencies not working together! Such incompetence has to stop.

Morris Haugg, Amherst

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