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[h=3]Cancer patients are being denied drugs, even with doctor prescriptions and good insurance[/h]
"Pharmacy benefit managers," not doctors, get to decide on which drugs a patient can have. While they decide, and appeals are made, cancer patients get sicker and sicker.
Cancer drugs are very expensive, into the hundreds of thousands of dollars. That's one part of the problem. The other part is managing care for the benefit of the pharmacy, rather than the benefit of the patient.
But that insurance didn’t ensure Smith would get the drugs she needed when facing CVS Specialty Pharmacy – the pharmacy their insurance required them to use. Cancer drugs prescribed by Smith’s oncologist were denied because they didn’t follow the standard protocol sequence of medications that Smith’s pharmacy benefit manager, CVS Caremark, had in their guidelines.
That means pharmacy benefit managers have the authority to trump a doctor’s medical judgment without seeing patients or knowing their full medical history, and without accountability for the consequences of what happens to sick people.
"Pharmacy benefit managers," not doctors, get to decide on which drugs a patient can have. While they decide, and appeals are made, cancer patients get sicker and sicker.
Cancer drugs are very expensive, into the hundreds of thousands of dollars. That's one part of the problem. The other part is managing care for the benefit of the pharmacy, rather than the benefit of the patient.