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Sun Mar 15 17:03:03 GMT 2009

Ken:

this is not the first time that the Louisiana State Formulary (covering all  
of the State University/Charity Hospitals and clinics, and usually crossing 
over  to the Medicaid formulary for the oral medications) has 'changed from On 
High.'  When I was in training, it was notable that our Chief of Internal 
Medicine got  letters of agreement from several of the larger pharmacies in Monroe 
to carry  the generics from the same manufacturer as prescribed by the state 
list at that  time, just to help make sure that our patients would remain 
stable after  discharge. In particular, the generics for digoxin, theophyline and 
warfarin  come to mind.

Consider Gov. Jindal, in his first job in the LA state government  (as Sec'ty 
of the Dept of Health and Hospitals)  turned the Medicaid  program around, 
and that he was later a major player in the US DHHS...I suspect  that this won't 
be the last cost cutting measure that will come out of Red  Stick.

ck
Charles S. Krin, DO

In a message dated 3/15/2009 10:06:09 Central Standard Time,  KMATTOX at aol.com 
writes:

This is  very interesting.   It borders, if not outright,  governmental  
practice of medicine.    These two drugs are NOT   therapeutically similar 
and for 
trauma, one of them has not been   validated.   One of these drugs has had 
problems with  increased  bleeding, and inadequate clot formation  
prevention.   It is 
alleged  that some deaths have been  attributed to the change to a 
"therapeutic  equivalent" drug without  the physician users being in the 
loop.    

k

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