Recently when I received a prescription for doxycycline hyclate at my insurance company's (Aetna's) preferred pharmacy, the copay was about $50. I objected, as I had gotten this prescription many times before at a copay of $1 to $2. The Walgreens tech, and the manager whom I then requested, told me that $50 was the correct price. I then stepped aside and called Aetna and was told the same.
At the time, I did not know that Aetna had made the hyclate salt a Tier 3 drug (tiers determine cost) and the monohydrate salt a Tier 1 — though the active ingredient, doxycycline, was the same for both salts. Both salts are equally effective. Both salts are Tier 1 in the Blue Cross and Blue Shield and UnitedHealth formularies — and perhaps others.
I since have spoken with numerous Aetna personnel about the doxycycline pricing (and perhaps the salts of other active ingredients) as indicative of a pricing system problem. Also, Aetna loads the retail pharmacy's computer with its formulary; it could also include a notification regarding equivalent salts, to ensure customer cost-effectiveness.
I finally spoke with a woman who said she was the "executive recovery unit specialist in the office of the president of Aetna." To no avail — she defended this practice as being justified by their Board of Doctors review. I am one of those patients who did not receive the same level of responsiveness as state Rep. Rod Hamilton ("The murky world of who decides drug access, price," Opinion Exchange, Feb. 19).
The placement of drugs in a given tier system varies by insurance company. The premium of an insurance plan is transparent; the placement of drugs in the tier system is murky. I appreciate the work of Rep. Hamilton, R-Mountain Lake, on the need for transparency price setting for pharmaceuticals.
Dee Oliveira, Minneapolis
FEMINISM AND ABORTION
'Real' movement respects choice, despite letter writer's definition
As a feminist (real, not phony) since the 1970s, I have to respond to the Feb. 26 letter writer who stated that "real feminists believe in respecting and protecting human life at every stage — from conception to natural death." The founders of the modern feminist movement have worked tirelessly for women to have equal rights, including the right to autonomy, abortion rights and reproductive rights, and many more. The bottom line is that women should have the right to choose; whether it is a job, voting or decisions about their body, it is only theirs and their partner's (if they have one) to make. Feminists do not judge what decisions other women make; we support and respect their right to be able to make choices in every aspect of their lives.
Karen Jaffee, Edina
FEMINISM AND WORKSPACES
'It's not about excluding men' — but it is if you exclude men
As a feminist male, I was troubled by "A women's place" (Feb. 25), which celebrated workplaces where "a lack of men" is a cure for pervasive sexism. I can't imagine that the solution to sexism is a segregated world where one gender withdraws from another. And let's all admit that a workplace that excludes workers because of gender is not a "sexism-free hub."
Paul Maravelas, Mayer
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