Patients and Physicians Speak Out

I have Medicaid, and I was denied a medication with preauthorization from a doctor. I have had migraines for the past 30 years, and she gave me 75 milligrams of Nurtec ODT (rimegepant). You take one pill every other day to prevent migraines. When I was taking them, for the first time in 30 years, I didn’t have a migraine. 

I suffer from them [migraines] probably about 17 to 20 days a month. They make me sick, as in vomiting, and I actually have to go to a dark room to lie down. It hurts so bad, and it also makes my eyes blurry. I understand it isn't a cheap medication, but it actually works. You don't know how that feels – to suffer from migraines and not have any [medication]. Then your insurance company denies your medicine that you know works and you can't afford it. Just like the time when I had to take a thyroid medication, .075 micrograms of Levothyroxine, and was denied by Medicaid. Seriously. So, what, am I supposed to not just take my thyroid medication? Which I'm not because I can't afford $107.00 a month for it. But even with the Nurtec ODT, insurers are denying someone’s medication, which the doctor says helps tremendously and isn't a generic brand. I have taken everything else that Medicaid said I could have, and it didn’t work...

Patients are dying while they are waiting for prior authorization when it comes to their cancer care. Care delayed is care denied. Cancer does NOT wait.

[Prior authorization] needs to be fixed because [this process] takes up valuable time that we should be using for patient care. In general, I spend a minimum of 30 minutes on the phone when requesting a peer-to-peer or appeal on a medication that I deemed clinically appropriate for my patient. That is time I could be using to review labs, call patients and make management decisions.