| |
You are here: Experts > Health/Fitness > Pharmacology > Pharmacy > Adacand vs Diovan
Pharmacy - Adacand vs Diovan
Expert: Barbara Judge - 10/30/2009
Question
QUESTION: Hello, I was diagnosed 5 years ago with CHF. At that time my ejection fraction was 17%. After getting a great doctor, who prescribed Adacand, Metaprolol, Spironolactone, and late, Digoxin, my ejection fraction returned to 65%.
Because I switched agencies, my insurance changed, and they wouldn't cover Adacand. They made me switch to Diovan. I've been taking it for about 8 months.
At my last echocardiogram, (after taking Diovan for 6 months) my ejection fraction went down 10%. I am worried that this could be due to the switch from Adacand to Diovan. What do you think?
PS I also have have occasional severe itching on one arm, there is nothing there to cause it.
ANSWER: Unless you had or could have an echocardiogram within a reasonably short period of time (3 months or less) between switching from Atacand to Diovan I don't think you can draw any conclusions about the change in drugs causing the change in ejection fraction. You can not expect to compare 5 year old results with current results. There are too many other variables which also change over time to be able to conclusively say that the switch from one ARB to another drug in the same drug class would have cause such a significant change without further testing. It does not mean the change in drugs did not cause the change in therapeutic outcome, it just means you don't have enough information to be absolutely sure one way or another.
As far as the itching is concerned, how long has this been occurring and did it begin in coordination with any specific event. Most allergic reactions are not limited to one specific area of the body unless it is a contact allergen where only that body part is in contact with the product/substance causing the allergic reaction. Try to look for new or different things you have added to your daily routine that may be in contact with that arm.
If you are noticing worsening symptoms you should of course contact your doctor when necessary.
Thanks
Barb Judge
---------- FOLLOW-UP ----------
QUESTION: Thanks for your swift reply. I just wanted to tell you that I get echocardiograms every 6 months. That's why I was concerned. The decrease in my EF occurred in the period that I switched to Diovan.
Thank you again.
Mary
Answer
If you can isolate the decrease in EF to the time frame when you were changed from Atacand to Diovan then you should have a good case for your doctor to file an appeal with your insurance company on your behalf. Depending on the insurance company many have review process already in place for situations such as yours. It is required of Medicare D providers. It is not required of private insurers or employer based plans. The worst thing that can happen if you appeal the need for Atacand is they still require you to take the Diovan that you are taking now. You have the documentation, I would work with your doctors office for a prior authorization or appeal.
Thanks
Barb Judge
Add to this Answer Ask a Question
|
|
