Patient brings in two sheets from Caremark. They recommend that she discuss blood tests with her doctor because of some meds she is on. One of the medications is a non-steroidal anti-inflammatory (NSAID) and the PBM (pharmacy benefit manager) recommends that she have LIVER function tests checked by her physician. Now kidney function abnormalities are many times more worrisome and common than liver problems with the NSAIDs. I have multiple patients in my practice with significant kidney damage as a result of NSAID use and I have never seen, in many years of practice, liver damage, though I know it is theoretically possible.
Seriously…when can we get the insurers and the PBMs out of the exam room so I don’t have to spend more time discussing issues that are not a problem, instead of the issues that we need to talk about?by