Cancer patients are being denied drugs, even with prescriptions and insurance
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Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#2> pharmacy benefit managers
The qualifications to become a pharmacy benefit manager include a bachelor's degree, at least five years of experience as a pharmacist, and five years in health plan pharmaceutical management.
So a bozo pharmacist can trump a doctor's judgment.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#3Can't wait for the US health system to make it to the UK.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#4Can't wait for the US health system to make it to the UK.
Seriously, if that happens I'm moving out of the UK. I've spent 9 years of my life here and even though it gives me weekly anxiety problems, I've plowed on through the whole brexit stuff, I've applied for the stupid right to stay the government implemented, I'm telling myself that the drop in the value of the pound is not that bad even though living here has been continuously and very visibly getting more expensive especially for the past 3 years......but if the NHS is dissolved or gutted enough that it stops being a public health service then me and my wife are selling the house, packing bags and just leaving for another EU country. I'm fucking terrified for the future. I really am. Cutting down on the news helps a bit but there is constant feeling of uncertainty.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#5This happens across the board.
I have psoriasis and psoriatic arthritis. The barriers to getting a prescription for an effective (and expensive) biologic medication can be crazy.
When I've been forced to use a "specialty pharmacy", they require that the medication be shipped overnight (it has to be refrigerated) which is clearly more expensive than picking it up at a neighborhood pharmacy, that shipment has to be arranged every month, which means a phone call, waiting on hold, passing a quiz on my condition, surviving attempts to upsell supplies I don't need. They also won't ship "too soon", which inevitably means that the monthly refills slightly more slowly than once a month
I've also had insurance demand that I take ineffective but cheap medication for 3 months before I can get the stuff that works -- ostensibly they want to see if the cheap methotrexate (daily nausea, waves of fatigue) is effective.
In the 11 years since my diagnosis I've managed to be regularly on an available effective medication about 60% of the time, mostly because of this nonsense. 40% of the time I'm in pain
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#6> pharmacy benefit managers The qualifications to become a pharmacy benefit manager include a bachelor's degree, at least five years of experience as a pharmacist, and five years in health plan pharmaceutical management. So a bozo pharmacist can trump a doctor's judgment.
A pharmacy benefit manager is not a person, it’s an organization. In this organization are usually doctors and pharmacists (who have doctorate degrees also), who review medicinal claims based on the policies set forth by the payer (sometimes an employer, sometimes an insurance company, sometimes the government).
They also don’t “trump” a doctor’s judgment, they simply state whether or not the claim for medicine is covered under the plan rules.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#7This happens across the board. I have psoriasis and psoriatic arthritis. The barriers to getting a prescription for an effective (and expensive) biologic medication can be crazy. When I've been forced to use a "specialty pharmacy", they require that the medication be shipped overnight (it has to be refrigerated) which is clearly more expensive than picking it up at a neighborhood pharmacy, that shipment has to be arr…
Look into Kratom for the in-between. Its cheap if you get it online, seems to be pretty safe, and works comparably to opoids for pain while being only minimally habit forming.
Edit: people don't seem too happy with this comment but it's a chance at legitimate relief from chronic pain with millions of daily doses in the US and no documented fatalities, excluding a handful of reports where other illicit substances were consumed simultaneously.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#8> pharmacy benefit managers The qualifications to become a pharmacy benefit manager include a bachelor's degree, at least five years of experience as a pharmacist, and five years in health plan pharmaceutical management. So a bozo pharmacist can trump a doctor's judgment.
A pharmacy benefit manager is not a person, it’s an organization. In this organization are usually doctors and pharmacists (who have doctorate degrees also), who review medicinal claims based on the policies set forth by the payer (sometimes an employer, sometimes an insurance company, sometimes the government). They also don’t “trump” a doctor’s judgment, they simply state whether or not the claim for medicine is co…
Haha I was about to write this. Agree that a PBM is not an individual person.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#9This happens across the board. I have psoriasis and psoriatic arthritis. The barriers to getting a prescription for an effective (and expensive) biologic medication can be crazy. When I've been forced to use a "specialty pharmacy", they require that the medication be shipped overnight (it has to be refrigerated) which is clearly more expensive than picking it up at a neighborhood pharmacy, that shipment has to be arr…
Look into Kratom for the in-between. Its cheap if you get it online, seems to be pretty safe, and works comparably to opoids for pain while being only minimally habit forming. Edit: people don't seem too happy with this comment but it's a chance at legitimate relief from chronic pain with millions of daily doses in the US and no documented fatalities, excluding a handful of reports where other illicit substances were…
Beware: “minimally habit forming” is anecdotal. There are many other anecdotes of it being quite addictive.
See quitting kratom on reddit for more info.
Re: Cancer patients are being denied drugs, even with prescriptions and insurance
#10> pharmacy benefit managers The qualifications to become a pharmacy benefit manager include a bachelor's degree, at least five years of experience as a pharmacist, and five years in health plan pharmaceutical management. So a bozo pharmacist can trump a doctor's judgment.
A pharmacy benefit manager is not a person, it’s an organization. In this organization are usually doctors and pharmacists (who have doctorate degrees also), who review medicinal claims based on the policies set forth by the payer (sometimes an employer, sometimes an insurance company, sometimes the government). They also don’t “trump” a doctor’s judgment, they simply state whether or not the claim for medicine is co…
>"They also don’t “trump” a doctor’s judgment, they simply state whether or not the claim for medicine is covered under the plan rules"
Not how it is described in the article. Is the article incorrect in your opinion?