From Lori Fagan
I have been living withrheumatoid arthritis (RA)for over a decade. As a full-time working mom and wife living with a chronic condition, the last thing I need is the added strain of fighting with my health insurer.
不幸的是，由于一种被称为“步进疗法”的常见医疗保险做法，过去10年一直是一场持续而紧张的战斗。
Step therapy, sometimes known as “fail first,”is when an insurer requires you to try and fail on one or more therapies preferred by the insurer before the patient is allowed to have the medication the physician deems most effective. In the meantime, your health hangs in the balance.
When I was first diagnosed with rheumatoid arthritis, my doctor knew based on my symptoms and test results which medication I needed. My insurance, however, required that I go on a different medication first, even though my doctor did not think it would be effective and had known side effects and risk.
I went on the insurance-preferred treatment and wound up with blurry vision and headaches. I was taken off the initial treatment and put on another that had more severe risks, including irregular heartbeat, liver and kidney issues. I failed on the second treatment fairly quick, and while I tried to get on a better treatment, the insurer-preferred medications were only mildly controlling my painful RA symptoms.
在与我的保险公司交涉了好几个月之后，我终于能够得到一种控制我的症状、副作用最小的药物。但这是一条漫长的道路。
Unfortunately, there are millions of people across the nation who are in my same position, and millions of patients who feel like no matter what the doctors and the tests say, they do not matter. Our country needs to make it possible for patients to quickly obtain exceptions to step therapy if their doctor determines that going through the process could threaten their health.
I’m doing my part in Virginia by raising awareness about step therapy ahead of our state legislative season. More than a dozen states have already taken action to limit step therapy. I shared my story as an op-ed in mylocal paperand you can too.Click hereto learn some tips on writing a letter for publication.
But we can all take action to help limit step therapy nationwide by calling on Congress to pass the Restoring the Patient’s Voice Act of 2017 (H.R. 2077). This bipartisan legislation provides a clear and transparent process to seek exceptions to step therapy review by health insurance plans, and also establishes a reasonable and clear timeframe for override decisions.
Share your step therapy storywith your members of Congress in support of this bill!
Related Resources:
- Arthritis Foundation Legislative Position Statement on Step Therapy
- Junior Ambassador Spotlight – Ethan Berkovitz, Ohio
- Ambassador Spotlight – Kerry Wong, New York
嗨，洛莉，听说我不是一个人，我很难过。我的故事略有不同。去年夏天，我更换了保险，并提醒新公司，我已经在服用一种药物，需要在药用完前几周获得预先授权。它们太难了，以至于我错过了三剂，并经历了难以置信的痛苦复发。然后情况变得更糟了。他们终于给我送来了药，但现在已经不起作用了。我的医生说，当你停止服用这种药物时，就会发生这种情况——当你重新服用时，它可能不会起作用。所以她给保险公司的专业药房寄去了另一种生物制剂的剧本，而我两周后还在等。讽刺的是，新药的价格只有一半。我的关节炎已经让我失去了两个臀部，现在我担心我的膝盖。