Letter Box


Doctor responds to prescription report

Editor of the Reformer:

After much consideration I feel obligated to respond to the article "Brand-Name debate: Local doctors struggle with drug decisions" by Mike Faher (Nov. 23-24).

The article ran adjacent to one indicting several national physicians for excessively prescribing name-brand drugs while accepting promotional or consulting fees from pharmaceutical companies. The implication (not subtle) was that the local providers listed as high percentage prescribing are somehow compliant. This impugns their integrity and trustworthiness.

The 2011 Medicare part D prescription data referenced regarding my practice concern glaucoma medications used to decrease intraocular pressure (not high blood pressure in the eye as mentioned in the article.) Timolol maleate is the generic which we have been using for years; Travatan Z (a prostaglandin analog) was only approved generically on March 28, 2011, consequently that generic (latanoprost) was essentially unavailable to my patients through 2011, the overwhelming majority of whom are now on this generic equivalent.

The phone call which was not returned to the Reformer was left on a home answering machine and was deleted by a family member who thought it was a solicitation. Any earnest effort to contact me prior to publication would have cleared up the article’s myriad misrepresentations. This lack of effort resulted in what feels to be lazy, "gotcha journalism." You owe the subject matter and your readers more due diligence.

I have spent nearly 30 years providing ophthalmic medical and surgical care to our community and the most important "medicine" in my "black bag" is the faith my patients and colleagues have that I am providing current, effective, and ethical care. I do not "struggle" prescribing generics when available and appropriate. Your article does both me and my practice a disservice.

Cost containment in medicine is a subject about which all care providers share deep concerns. Please show more fairness and responsibility in future reporting.

Dana McGinn, MD, FAAO,

Brattleboro, Nov. 23

Decommissioning concerns

Editor of the Reformer:

Thanks to Bob Audette for continuing to cover the decommissioning issues at Vermont Yankee ("Vermont Yankee Decommissioning Costs Could Include Spent Fuel Handling," Nov. 25).

Spent fuel management, taking very radioactive fuel out of the reactor and into dry storage casks on the outside pad, is expected to be about one-third the cost of taking apart the reactor itself. Entergy Nuclear, in filings before the Vermont Public Service Board, expects this cost to be fully reimbursed by the U.S. Department of Energy, but this is wishful thinking. As a result of court suits against DOE, other utilities have been reimbursed 75 percent to 78 percent of the spent fuel management costs.

As part of the Standard Contract with DOE, utilities have always been responsible for packaging the spent fuel into canisters, and into overpacks for transportation to a repository. But since there is no repository, utilities remain responsible for the cost of packaging the fuel. For example, the total cost to SoCal Edison for spent fuel management was estimated at $380 million per reactor, but reimbursement will only be $297 million. Once Vermont Yankee closes next year, Entergy Vermont has only one pot of money to make up the difference, the decommissioning fund, unless the parent company, Entergy, comes to the rescue.

Hopefully Vermont taxpayers won’t be called on to make up the difference.

Marvin Resnikoff,

Bellows Falls, Nov. 25


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