Comments with support for the bill.
I have Chronic incurable diseases. One is Gastroparesis. I can’t afford to have my doctor’s and insurance play with my life. Doctor’s know do no harm. Why is the government getting involved with our care. I have been ill for 20 years and never have been an addict. My doctor’s know what I truly need. Let them take care of the Critically ill.
Because of the step therapy I have been denied treatment by insurance doctors have requested. I have been denied medications/nutrition requested by doctors, as the doctors first choice of treatment. Therefore, with insurance, I have ended up paying thousands of dollars for medication, nutrition, treatment after following insurances recommendations. Only to have them fail. At 88 pounds, put on Palliative Care, I do believe my doctors and care team know what’s in my best interest over some coder at an insurance company. Our care team, physicians, doctors see us first hand, insurance doesn’t. So when a doctor requests a specific medication it’s in our best interest to have access to the medication rather than what insurance would like to cover. I believe step therapy has been to many people demise because they don’t have the means to afford the medication/treatment their doctors prefer, as well many insurances won’t cover what the patient truly needs to have. Our doctors should have the right to treat, medicate and prescribe what’s in their patients best interest over a coder at an insurance company that knows nothing about us!
So my experience with step therapy is very madning for me. There is only 1 FDA approved medication for Gastroparesis Reglan. So the doctor naturally prescribed it. What choice does she have right? I call to get the status and a prior authorization is need. Why would one be need for the only med approved. So after a few weeks of the dr submitting paper work they say we need to try something else? What? So we ask what are they recommending? We check erythromycin. But they required a prior auth with that one too. That was also rejected stating to try another medication. I paid out of pocked at wal mart for 4 bucks for reglan that comes with a balck label because of the high rick of side effects. Which after a few months i developed. I paid out of pocked the whole time. So at my next appointment we switch to erythromycin because we followed protocol. Its been two weeks and i still have not got my medication because they dont want to approve it. Its almost 200 bucks out of pocket. I can’t afford that. What options do i have? I spent every day for two weeks on the phone following up. Missing what little work i have because i am sick. This process is a joke and has made me not want anymore medical treatment. Change this now. It is inhuman treatment and honestly torture by paperwork and red tape.
In 2007 I had a giant fibroid that took up my abdomen & pushed my intestines through my diaphragm into my chest. When they removed it they took my ovary, my appendix, & told me to see a surgeon right away for the diaphragm repair as they couldn’t fix it when they did the removal as they put me to sleep twice that day, once to evaluate via endoscopy & then to do the removal. They also said I had another growth on my other ovary, but it was only 3cm so they left it. In 9 months that growth grew to 9cm & I was given a total hysterectomy. The surgeon I met with immediately after the first surgery stated I was too young for hernia surgery & started me on PPIs instead of fixing the structural issue. I spent the next several years with ulcers & illness until I was finally given a nissen fundaplication as my stomach was in my chest. They found barrett’s esophagus during this procedure and sent me for radiation ablation, (told 6 burns, given 50). This caused an esphogeal stricture & the surgery to fail. After 11 dialtions I was able to swallow again but still require dialtions regularly. The nissen fundaplication was repaired as well but unfortunately failed two more times, (3 total nissen fundaplications, all failed) I’m now inoperable with dense adhesions, I’m sick everyday & disabled from the pain, nausea. & digestive issues I have daily. I believe my life would be completely different if they were allowed to treat everything they knew was wrong with me when it was all known in 2007 when I had the giant fibroid removed. Had they removed the additional growth they found & repaired the diaphragm I believe I wouldnt have suffered all these years & wouldn’t be disabled today. Please don’t let anymore people become profit for the health industry with the step process. Thank you!
I have personally been affected. Who wants to keep trying medicine that doesn’t work. My dr actually said, it probably won’t work, but we have a process to follow. Tried useless meds that created horrible effects. It took going through several medicines to get to the one they wanted me to try. This is wrong. I as a patient, should be able to skip to the medicine that’s best for me and stop taking ones that just make me suffer.