Friday Rant: Pennywise, Prevacid Foolish – Spend Lessons from Coupons at Costco
After buying the usual items -- mostly food, and other related consumables -- I decide to take advantage of a coupon for a drug called Prevacid. Prevacid, like other strong stomach acid reduction drugs which are typed as proton pump inhibitors (or "PPI"s), is powerful stuff. Still, it's marketed, of course, as having exactly the same impact as its competitors (but the underlying chemistry, as I would soon learn, is different).
I assumed Prevacid and Prilosec were interchangeable, and given the price differential with the coupon -- clearly designed to entice people like me, because the drug had only recently gone on the OTC market -- I thought I'd give it a try. A week or two later, I cracked open the bottle after a particularly big meal in which I thought it would come in handy. By the next day, I had a number of odd maladies that I initially thought were tied to the flu: shortness of breath, nausea, tendon/muscle pain, etc. The symptoms continued to worsen and by the next week, I had seen my doctor twice, gone through numerous tests and procedures, and tapped my HSA account for a good grand or two even after the PPO discount (I'm still waiting on the adjusted bills). However, nothing seemed to improve.
Even though my risk factors for nasty things are low (heart attack, cancer, etc.), the symptoms continued to culminate, and I began to worry that something very dangerous was brewing under the surface. Yet my doctor was stumped: my test results came back completely normal. During this time, I also managed to spend a few hundred bucks seeing an acupuncturist, hoping a bunch of needles would help, which they did for a period of time after each session. In my mind, however, this further suggested that there really was a horrifying underlying problem that desperately needed treatment. Even still, my overall condition worsened and I even had to stop running and lifting weights because of upper chest, shoulder and other pains (those who know me understand that this a major thing, given the importance I place on getting a workout in most days of the week).
As things got worse, I was at a loss. Last weekend, however, it dawned on me that the symptoms began around the time that I tried Prevacid for the first time. I went to Google, typed in "Prevacid side effects," and what I found shocked me -- numerous examples of other individuals who battled my exact symptoms. A number had also bought Prevacid with a similar coupon offer, thinking they'd give it a try as a substitute of Prilosec or another acid reducing drug. Upon reading this, I immediately put two and two together and tossed out my remaining pills.
Things were better by the next morning, and 48 hours later, I was 80% back to normal. I even gave a webinar without any signs of breathing problems or nausea (the previous week it was all I could do just to get through a series of meetings in the UK, let alone presenting materials). For me, the simple Spend Management lesson in all of this is fairly clear: don’t be pennywise, Prevacid foolish. In a silly attempt to save a few bucks, I ended up spending over a thousand dollars on tests and treatment, hurting my work and athletic performance, and giving myself quite a serious scare in the process.
We all need to remember that even OTC drugs are serious things. Just as we think of traceability in our company supply chains, there are lessons here when it comes to traceability in our personal supply chains as well (i.e., think about the timing of the onset of symptoms and associate with changes in personal consumption or behavior). When it comes to diagnosis and treatment, we must stop an incident in its tracks before it becomes all-consuming, which it nearly did in my case. Something as seemingly innocuous as trying a substitute a product because of a cheaper price point can have disastrous results for some people who end up with an underlying allergy to a medicine. As a final aside to this story, my doctors and everyone else had failed to even ask if I was on any prescription or OTC drugs, or whether I had changed any behaviors or products (if anyone else encounters this same problem, I was not taking any other drugs, prescription or otherwise). So much for treating the whole patient, I suppose. In the end, only a free search on Dr. Google ended up saving the day.
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Not to say that Prevacid does not cause the issues noted in the piece, this one sentence contains another issue. People taking medicine that they don't understand. PPIs are not something you 'crack open' like a bottle of Tums.
Even without the side effects, the author's experience in this situation would have been failure.
To be exact, I had not taken a pill earlier in the day. I had forgotten. But I had taken another PPI the previous early morning before. Thanks for sharing the clarification and thoughts -- you are correct.
Buying a long-term dose of any new medications you haven't had before is also clearly a bad idea. No doctor is going to hand a patient a 90 day prescription of a new drug. Similarly, no patient should every buy a drug at Costco they haven't taken before, because all you can buy at Costco is the equivalent of a long-term prescription.
I've been on a PPI for 17 years, and during that time I've had health insurance companies and hospitals switch the PPI I'm on numerous times. They do that because the drugs in that class are considered medically equivalent, and they can save money by carrying/covering only one or two of the class. But individuals have individual reactions to chemicals; each person may find that a different one works best for themself, and on rare occasion an individual will have a bad reaction to one, as you did, that they didn't have to others.
The medical personnel you saw absolutely should have asked about what medications you were on. But that obviously doesn't happen nearly as often as it should, so it's up to each individual patient to keep track themselves. You may no choice but to use a different PPI at some point in the future, for reasons that have nothing to do with money, so the most important thing you should learn from this has nothing to do with spending.