Wednesday, November 06, 2013

What the hell is AETNA/other insurances thinking with this "Step Treatment"? Check this out, few readers and NSA types:

"For Tecfidera
  • A documented diagnosis of relapsing remitting multiple sclerosis AND documentation of all of the following:
    • Discontinuation of other therapies used for treating multiple sclerosis while on therapy with Tecfidera (Note: This does NOT require having to discontinue Ampyra)
    • Recent (within 6 months) complete blood count (CBC)
    • A documented contraindication or intolerance or allergy or failure of a one month trial each of the following preferred alternatives, Avonex or Rebif AND Copaxone"  
So essentially, poke yourself for two months to be sure you have an allergy, failure, or intolerance to the ABCR drugs before taking a drug that so far has shown promise and works better for the most part than these drugs. And oh yes, you can ask for a medical exception...provided someone is willing to put in the paperwork.

EVERY one of the first line MS drugs have been put on this step list, including Avonex. I'm trying to get my brain around the puzzle... who figured out what one should take before insurance will ok Avonex? Is Extavia ok to use as a 'step' to Copaxone? I mean what the hell?

Oh, I'm cranky-angry. This is stupid stuff.  Can I go to my insurance rep and poke him or her with needles for a month or two and see how tolerant THEY are?

Grump, grrr, bah!