I wholeheartedly support the concerns expressed in Evan Hempel’s April 6 op-ed “ ‘Fail first’ fails patients.” article. However, it only tells a part of the story.
As a physician, I can attest that the current environment regarding prescriptions is fraught with pitfalls, unreasonable demands, and dead ends set up by pharmacy managers and management companies. It is a veritable obstacle course that stymies any attempt to get patients medications that can best help them.
The amount of time necessary to deal with these roadblocks is staggering, taking away from the time that could be spent helping patients. Even when the authorizations are successfully obtained, insurers find ways to further delay the patient’s receiving the medication.
If insurers’ rejections result in patients being hospitalized, the insurers bear none of the financial burden. Therefore, they can arbitrarily make these absurd policies with total impunity.