Hendrix's Eccentric Commentary

2/20/2025

I have been seeing a nephrologist who is attempting to treat my hypertension and kidney disease.  As part of the attempt to control my blood pressure the doctor prescribed doxazosin mesylate (generic Cardura) 2mg tablet once a day.  After 3 months the doctor decided to up the dosage to a 2mg tablet twice — then things got interesting.

I received a letter from my health insurance, Medical Mutual of Ohio, via their pharmacy benefits manager, Express Scripts, informing me that they would not pay for doxazosin mesylate twice a day as this was not the normal dosage. They told me to consult with my doctor.

A phone call to my nephrologists office ensued:  I explained the situation and said the doctor needed to either apply for an exception to the ruling or find an alternate drug.  I was told that the message would be passed on to my nephrologist, which indeed it was.  It appears they contacted Express Scripts.

I received a phone call from my nephrologist’s office yesterday.  Medical Mutual/Express Scripts would not pay for two 2mg tablets of doxazosin mesylate twice a day — however, they would pay for a 4mg tablet once a day, which I would then split into two tables and take twice a day.

Does this even begin to make sense?

Such is the state of health care in the United States.