Oneida family fighting insurance after it stops covering $4,000 life-saving medication

[Jilly_in_VA]

ONEIDA, Tenn. — Robin Newman was at church, just like any other Sunday, when she started feeling sick. She left and went to the local emergency room.

"They thought initially it was anaphylaxis, and she was allergic to something," said her daughter, Alex Geisler. "She was intubated within about 15 minutes."

That was in July 2020. Since then, she's been diagnosed with idiopathic angioedema and hospitalized more than 40 times.

There's a shot that helps reverse the swelling and reduce the need for intubation. But at $4,000 a dose, Firazyr is pricy. The medicine works by blocking a chemical from binding to receptors, preventing inflammation. For a while, Newman's insurance covered the shots she needed. Then, Geisler said they were told it would no longer be covered.

https://www.wbir.com/article/news/health/the-difference-between-life-and-death-oneida-family-fighting-for-insurance-to-cover-life-saving-medication/51-2f1a9777-5380-4e65-8f68-3f52dd7d8639

(This may more properly belong in Health, but I couldn't find the exact place to put it there either. Sorry.)

SINGLE. PAYER. NOW. DAMMIT.

[dalton99a]

1. We have a barbaric system

that kills the poor and enriches the rich

[Phoenix61]

2. I wonder if they cover this.

https://www.haegarda.com/difference?utm_source=google&utm_medium=cpc&utm_campaign=unbranded_HAE&gclid=EAIaIQobChMI3vnbr7Oc8QIVWx-tBh0BtwXiEAAYAyAAEgKwQPD_BwE

[chriscan64]

3. We have been fighting the insurance company for weeks.

I don't have time for the full story, suffice to say that my wife's compromised immune system makes any infection dangerous. She developed a respiratory infection for which her doctor prescribed some antibiotics. The treatment was working but when the pills ran out, the infection came back so she needed a refill. When we went to pick them up, the pharmacy told us that the insurance company refused to cover the prescription because the doctor wrote tablets instead of capsules. This was the doctor that the company selected for her.

Reaching the doctor or insurance company by phone is next to impossible, so as she struggled to get the refill, the infection raged to the point where she had to be admitted to the ICU. Their penny pinching over the price difference between capsules and tablets cost them the price of a three day hospital stay. The hospital refused to draw blood from her port, their policy is to try to start an IV in the typical places which do not work for her. She was tortured by several attempts until they gave up and put one in her femoral artery.

All of this pain, suffering and stress was over capsules versus tablets. For a topper, they refused two of the five prescriptions the hospital wrote upon her release.

[multigraincracker]

4. I bet it cost the Pharma co. Less than 50$

To make it and the rest is profit. What does it cost in other countries?