How's your meds ??

On Friday, July 24, 2009, I mentioned two pieces of transplant legislation that I've had the honor of working on with the Tennessee legislature. One, HB 635 / SB 109, would have required Tennessee pharmacists to notify a transplant patient's physician anytime the patient's immunosuppressants were changed for whatever reason. The bill did not have the votes to make it out of subcommiteee but a compromise was reached.

You may be asking - why was this bill important ?? Right now in Tennessee, a patient's medication can be changed, unless it is an anti-seizure medication, without first notifying the physician. With most medication, it's not a big deal. However, with immunosuppressants it can be. An optimum level of immunosuppressant must be maintained in a transplant patient's bloodstream at all times. Too little and the patient can go into rejection quickly. Too much and the patient can suffer serious side effects, such as high blood pressure and cholesterol, which can lead to a stroke or a heart attack. Also, decreased kidney function can occur leading to possible kidney damage and renal failure. The patient's physician can determine the optimum level based upon his or her experience with the patient. If an immunosuppressant is changed, the physician needs to order labs to make sure the blood levels remain at the optimum level for that patient.

The opponents of HB 635 argued that there is no difference between the different immunosuppressants whether it be brand name vs. brand name, generic vs. generic, or brand name vs. generic. Supporters of the bill argued that there could be significant differences. Recently, I ran across the ABC News video "Are You Getting the Right Prescription ??" (click on link below to view) showing there are differences between medications backing up the claims of the supporters of HB 635. In fact, in the video the American Pharmacy Association goes on record as supporting physician notification. Even though immunosuppressants are not mentioned in the video, many transplant physicians believe there are differences among them. Think about it. It only makes sense. If there can be differences within one type of drug, it's reasonable to believe there could be differences between immunosuppressants ?? The video contradicts the arguments of HB 635's opponents based upon one woman's real life story. In my opinion, there is no better evidence than that.

http://abcnews.go.com/video/playerindex?id=8190616