Are People with IBS in the U.S. Having Difficulty with Access to Certain Medications?

August 30, 2016

The pharmaceutical company Mylan has received intense negative publicity recently over significant price increases for Epipens, epinepherine autoinjectors for use in life-threatening allergic reactions. However, the University of North Carolina Center for Functional GI and Motility Disorders also shared on social media an NBC News article that claims many other Mylan-supplied prescription medications have also experienced significant price increases over time. These include dicyclomine (Bentyl), an antispasmodic used by many people with IBS  and metoclopramide (Reglan), a prokinetic commonly prescribed, among many other uses,  for  gastroesophageal reflux disease (GERD) and other gastrointestinal conditions that may coexist with IBS.  As both are generic drugs, each has several suppliers. Not all individuals using these medications receive them from Mylan, but as one generally has no control over the specific distributor used by a given pharmacy, this issue is a potential concern.

Also, a moderator of a large Internet support group passed along an August 12, 2016 blog post from the website GoodRx.com detailing the removal of numerous prescription drugs from the 2016 formulary lists of Express Scripts and Caremark. Express Scripts and Caremark are both companies that administer pharmacy benefits and mail-order pharmacy services for U.S. health insurance companies, self-insuring employers and in the case of Express Scripts, TRICARE, the insurance system for active, reserve or retired U.S. military personnel, some National Guard members, and military family dependents. The formularies are lists of specific medications approved for coverage. In the U.S.,health insurance is traditionally an employer-based benefit for the largest subset of citizens and residents, and typically,  employees have limited or no choice in the specific insurance plans offered to them and/or their families. Thus, again, one would most likely have no control over which of the two companies with which one’s insurance provider has a contract. From the linked lists, it appears lubiprostone (Amitiza), a chloride channel activator, which is FDA approved in the U.S. for use by women with irritable bowel syndrome with constipation (IBS-C), has been newly excluded from the Caremark formulary. Duloxetine (Cymbalta), a selective serotonin-norepinephine reuptake inhibitor is used by some people with IBS for pain and/or commonly coexisting depression and/or anxiety. It has also newly been dropped by Caremark. This issue would also appear to merit possible concern.

So IBS Impact asks U.S. readers, are these media reports consistent with real world experiences? Are people with IBS having problems getting access to medications they take regularly? If so, is either of these reported issues a widespread, systemic problem for individuals or certain subgroups in the IBS community? Please feel free to leave comments on this post.

 


Updates to IBS Impact.com for August 2016

August 19, 2016

Over the past few months, IBS Impact has been working on the latest round of updates to our main site. This is always a work in progress as new and useful information comes available, but this is a good time to draw readers’ attention to some of the changes.

There have also been new details and resources added in the latest news column on the left of the home page,  IBS page, advocacy page, research pageIBS studies page, resources pageIBS and children page and links page. Of particular interest are the progress of HR 2311, the Functional Gastrointestinal and Motility Disorders Research Enhancement Act, currently under consideration in the U.S. House of Representatives, and updated information for the recently released Rome IV international diagnostic criteria. A couple of new pediatric clinical trial opportunities have been added as well.

Readers interested in the most recent news, events, clinical trial and advocacy opportunities, and articles between main site updates, may follow this blog or our Facebook or Twitter feeds (links found on the lower right sidebar of this blog). Regardless of one’s interest in IBS, whether personal or professional, most users should find useful and interesting material and links. The current site reflects resources in six countries which are among the top sources of hits to the site and this blog.

Because of the redesign and transfer of the site to new hosting in the fall of 2015, some links embedded in older posts on this blog or search engine results relating to IBS Impact.com may result in error messages, but you should still reach the site itself. If so, please use the navigation links at the top of the site to reach the desired subpage.  No information that is still currently useful has been removed from the site, although in some cases, the location has changed. Only outdated details and occasional defunct links for which there is no replacement available at this time have been deleted.

Please feel free to check out the site here. Our goals with the website, blog and social media are to provide a varied range of current, scientifically accurate, reputable information and resources to people with IBS and their families and friends, and to encourage informed choices, proactive self-advocacy and public awareness of IBS, and the unmet medical or social needs many of us face as a result of IBS.

IBS Impact as an entity, is not directly affiliated with any other organization, site or research sponsor and receives no funding for the information we post on the main website, this blog or our Twitter and Facebook pages. We do welcome constructive collaboration and value the many individuals, websites, organizations and clinical and research entities who continue to support, encourage and amplify our efforts in various ways to benefit the cause of IBS awareness and advocacy worldwide.

Comments, suggestions, corrections of outdated links, article submissions, and clinical trials or surveys by researchers affiliated with academic, medical, or pharmaceutical entities or reputable organizations representing IBS or commonly overlapping conditions in any country are all welcome and will be thoughtfully considered.  A contact form can be found on the home page of the main site, or comments can be left on this blog.  Thank you to all of our readers and social media followers for your interest and participation.