Action 9

Action 9: Your pharmacist may give you a different drug than your doctor ordered

CHARLOTTE, N.C. — Bob Brandon had a stroke about 15 years ago.  He's been on blood pressure medicine ever since.  The last ten years he's been on Losartan.  "Had no real problems.  My blood pressure stays at a really good level, 120 over 80 or even lower," he told Action 9.

But, recently, his pharmacy swapped that medicine for another in the same class of drugs.  "When I took this new medicine, it was just like I wasn't taking any blood pressure medicine whatsoever.  I was up to about 195 over 105.  That's stroke territory."

Lynn Crisci was in a cafe right near the Boston Marathon bombing.  "I saw the entire thing go up five stories high and then nothing. People just disappeared into it," she said.

She had severe headaches after that.  Her doctor prescribed Sumatriptan.  But the pharmacist gave her Naratriptan, the only drug in the same family her insurance would pay for.  She says it didn't stop the pain.  "I just hand it to the pharmacist and it's their job to put the right pills in the right bottle whatever it is.  It just never occurred to me that this was not what my doctor prescribed," she said.

Crisci and Brandon eventually found out about the substitutions and got the pills their doctors ordered.  "Within an hour and a half, I was back down to 135 over 88.  Now that is really good.  It's moderately high, but still that's alright.  I can live with that," Brandon said.  "We have to depend on our pharmacy and, when we get something that doesn't do it, we're totally shocked and we're also vulnerable.  And that's the way it was with me."

"For someone who was begging, begging for someone to help her die, this is a miracle," Crisci said.

Sometimes, insurance won't cover a certain drug or cover as much as another one in the same family.  So the pharmacist will make the switch.  It's called therapeutic substitution.  It's perfectly legal.  Pharmacist Todd Brown sayd most patients handle the switch without problems, but that some do have negative side effects.

"It works the same way, it's within the same class of medication, but it's not the exact same medication," Brown told Action 9.  "Either the patient hasn’t responded to the lower-priced medicine or they’re allergic to something in the medicine. All sorts of things could happen. But, I’d say nine times out of 10, there would be no reason not to use the lowest priced one."

Your pharmacist should let you know he or she made the swap and clear the substitution with your doctor first.  But you should also be your own best advocate.  Know what your doctor prescribes and see if the medicine you're getting is the same.  Look at the bottle.  If you have questions, don't be afraid to ask.