5iHuman Virtual Patient Encounter- Abdominal Assessment Assignment
Considering Affordable Treatment Alternatives
If the patient did not have prescription drug coverage, the treatment plan would need to be adjusted to provide more affordable alternatives. The current plan includes omeprazole 20mg twice daily, amoxicillin 1000mg twice daily, and clarithromycin 500mg twice daily.
Out-of-Pocket Cost
The estimated out-of-pocket cost for these medications is high. A 30-day supply of generic omeprazole 20mg capsules is about $20, generic amoxicillin 500mg capsules is about $20 for 21 capsules, and generic clarithromycin 500mg tablets are about $100 for 30 tablets (GoodRx, 2023a; GoodRx, 2023b; GoodRx, 2023c; GoodRx, 2023d). So, the full 30-day triple therapy regimen would cost approximately $140 out-of-pocket without insurance. This cost would be prohibitive for many uninsured patients.
More Affordable Regimens
There are a few options to reduce the cost of treatment if the patient does not have prescription coverage. One option is to replace clarithromycin with metronidazole in the triple therapy regimen. Generic metronidazole 500mg tablets cost approximately $10 for a 21-day supply (GoodRx, 2023b). Thus, substituting metronidazole for clarithromycin would reduce the overall cost to around $50 for a 30-day treatment. Another option is to use over-the-counter omeprazole (Prilosec OTC) instead of prescription omeprazole. A 28-day supply of Prilosec OTC 20mg capsules is approximately $25 (Amazon, 2023). Combined with generic amoxicillin and metronidazole, the total 30-day treatment cost would be around $55 without insurance.
Efficacy Considerations
While the alternative regimens have slightly lower efficacy rates than clarithromycin triple therapy, studies show they remain effective first-line treatments for H. pylori infection (Buzás & Birinyi, 2023). The metronidazole triple therapy has an eradication rate of over 80%, while the OTC omeprazole dual therapy has approximately 75% efficacy. Though not quite as effective as clarithromycin, these affordable alternatives provide cheaper options without compromising care significantly. Specifically, the metronidazole regimen substitutes clarithromycin for generic metronidazole, which costs around $10 for a 21-day supply (GoodRx, 2023c). Adding affordable metronidazole to omeprazole and amoxicillin reduces the total 30-day treatment cost to $50 for uninsured patients. While this regimen’s 80% efficacy rate trails clarithromycin therapy by a small margin, it remains a recommended first-line treatment that balances effectiveness and affordability.
Similarly, using over-the-counter Prilosec OTC instead of prescription omeprazole also offers savings. A 28-day supply of OTC omeprazole costs approximately $25 (Amazon, 2023). Combined with generic amoxicillin and metronidazole, the total cost is only $55 for a month of treatment without insurance. This OTC omeprazole regimen has an eradication rate of 75%, just slightly lower than prescription therapy. Therefore, it stands as a reasonably effective option tailor-made for patients without prescription drug coverage. It is noteworthy that though insurance helps offset costs, these alternate triple and dual therapy regimens provide the next best affordable options for H. pylori eradication, with efficacy rates approaching prescription clarithromycin therapy. Uninsured patients can still receive cost-effective first-line treatment without facing prohibitively expensive medications.
Local Prescription Assistance Resources
Yuba City offers several resources to help uninsured patients afford medications: The Yuba City Health Center Pharmacy provides sliding-scale discounted medications tailored to low-income residents’ ability to pay. This safety net helps the most vulnerable area residents gain access to affordable prescriptions. Similarly, Rideout Regional Medical Center’s Prescription Assistance Program offers free or reduced-price medications based on uninsured patients’ financial needs and eligibility. This further increases access to prescription affordability.
In addition, discount programs like GoodRx and SingleCare allow uninsured patients to save substantially on medications at nearly any pharmacy using coupons and discounted pricing (GoodRx, 2023). These widespread savings mean treatment affordability is not limited or confined to specific pharmacies. With a patchwork of lower-cost medication alternatives and financial assistance programs, uninsured Yuba City residents can still obtain dramatic prescription savings. Lack of insurance does not mean a lack of affordable access when it comes to key medications like H. pylori antibiotic regimens.
References
Amazon. (2023). Prilosec OTC frequent heartburn medicine and acid reducer tablets, omeprazole magnesium 20.6 mg – 42 ct. https://www.amazon.com/Prilosec-Frequent-Heartburn-Medicine-Reducer/dp/B0014E1FP0#:~:text=This%20product%20is%20to%20be,before%20eating%20in%20the%20morning
Buzás, G. M., & Birinyi, P. (2023). Newer, older, and alternative agents for the eradication of Helicobacter pylori infection: A narrative review. Antibiotics, 12(6), 946. https://doi.org/10.3390/antibiotics12060946
GoodRx. (2023a). Amoxicillin. https://www.goodrx.com/amoxicillin
GoodRx. (2023b). Clarithromycin. https://www.goodrx.com/clarithromycin
GoodRx. (2023c). Metronidazole. https://www.goodrx.com/metronidazole
GoodRx. (2023d). Omeprazole. https://www.goodrx.com/
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PLEASE WRITE REFLECTION QUESTIONS, I ATTACHED THE MANAGEMENT PLAN FILE
Week 5iHuman Virtual Patient Encounter: Abdominal Assessment Assignment
Reflection:
5iHuman Virtual Patient Encounter- Abdominal Assessment Assignment
Address the following questions: Review the Healthy People 2030 Health Care Access and Quality links to an external site. objective related to prescription medications. Consider how your treatment plan might change for this patient if he did not have insurance coverage for prescriptions. What is the cost of the medication you suggested in your treatment plan? Is there a more affordable alternative? What resources are available to patients in your area who do not have insurance coverage for prescriptions? Include the following components:
I. Answer all questions in the reflection prompt
II. demonstrate clinical judgment appropriate to the virtual patient scenario
III. Cite at least one relevant scholarly source as defined by program expectations
IV. communicate with minimal errors in English grammar, spelling, syntax, and punctuation