The first paragraph states, "When insurance twice refused to cover a nearly $800,000-a-year drug that Paxton Pope’s doctor believed could dramatically reduce his frequent seizures, his family initially braced for a serious medical setback."
Why does a drug cost $800k in the first place?
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This is the real kicker.
It’s probably $800,000 in the US, and like $500.00 everywhere else.
Because it's a predatory business that exploits the fact that people will bust their ass to find a way to pay simply so they can live and function. Especially when it's a parent with a sick child.
this isnt even on the insurance why does a drug cost 800k a year?
Likely because of insurances. The whole system is fucked beyond belief.
American healthcare is systematic murder
The denial letter the patient receives details the appeals process. This is not a secret.
There are so called "orphan drugs" which are rarely used and for rare diagnoses that are expensive to produce. Not sure if this is the case here.
It's still all bullshit but this is clickbait.
The denial letters I recently received is beyond ridiculous. Don’t pretend it’s an easy process.
I didn't say it was easy. I'm not an insurance agent. I despise the entire system. The letter even comes with the form you submit to the state and instructions on how to complete and submit it.
It's garbage. Reviewing specialists are not practicing doctors. Care is delayed. Preventative and interventional care steps that providers know will not work are forced to be tried first. Providers cannot treat their patients effectively.
We have every right to be mad. I'm just pointing out that the article keeps mentioning external appeals like they are this "one weird trick discovered by a mom that insurers HATE".
The insurance industry in America is beyond ridiculous let alone the pharmaceutical industry.
Orphan drugs? You’re paying for the R&D needed to create it, and it’s usually on the bleeding edge of science.
I’m not saying it’s right, but that’s why they have such insane prices.