Regence BlueCross BlueShield of Utah’s denial of coverage for the FDA-approved cancer drug Perjeta, prescribed by a specialist for a patient’s breast cancer treatment, exemplifies a critical flaw in the healthcare system. This denial contradicts established clinical guidelines and expert consensus, forcing the family to potentially shoulder over $160,000 in out-of-pocket costs. This case highlights how insurance companies obstruct access to necessary life-saving treatments, leaving patients in a precarious situation. The urgent need for systemic reform, including universal healthcare, is underscored by this and countless similar experiences.
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The situation is truly disheartening: a medical student, facing a potentially life-threatening condition, is having her crucial medication denied by her insurance company. She reports that despite numerous attempts to get authorization, including submitting extensive documentation and appeals, the insurer, Blue Cross and Blue Shield of Kansas City, remains steadfast in its refusal to cover the medication, Promacta (Eltrombopag), for her immune thrombocytopenia.
This isn’t an isolated incident; many people share similar experiences with insurance companies putting profits over patients’ well-being. Stories abound of individuals forced into repeated emergency room visits for necessary treatments simply because their insurance company won’t cover the medication from an out-of-state pharmacy or insists on generic alternatives despite documented ineffectiveness or harmful side effects.… Continue reading
John Q. Hosedrinker 
Matt Underwood