“The whole point of pain management is to take the least amount of medication possible to manage your pain, so that you always have somewhere to go when the pain increases or changes,” she wrote to us. “This is irresponsible and scary ‘cost management.’ ” She did not want us to use her name, saying her employer prohibited her from identifying herself, but she allowed us to share OptumRx’s redacted letter.
Her pharmacy benefit manager, she wrote, is “effectively contributing to the ‘opioid crisis’ with its own policies.”
A spokesman for UnitedHealth, Matthew N. Wiggin, said it takes the crisis seriously and wants to ensure that people with chronic pain get the appropriate treatment.
The New York Times would like to hear from people about their experiences paying for prescription drugs.
We’ve closely followed the opioid crisis and efforts to hold various parties accountable, among them drug manufacturers, pharmacies and emergency room doctors.
But these stories — about patients who believed their insurers were placing roadblocks in the way of less risky painkillers — felt new to us. The resulting article is on Monday’s front page.
We followed up with several of the readers, and searched social media sites like Twitter and Facebook to see if other patients were talking about this (they were).
Then we asked for documents: billing statements from insurers, denial letters, call logs and doctors’ records. In the case of our lead example, a woman named Alisa Erkes, she also agreed to sign a privacy waiver allowing her insurer, UnitedHealthcare, to comment on her case.
Charles enlisted ProPublica’s deputy data editor, Ryann Grochowski Jones, to analyze data from Medicare prescription drug plans. The results showed that insurers were indeed placing more barriers to drugs like Butrans and lidocaine patches than to cheaper generic opioids.
Insurers say that they are doing their part by placing limits on new prescriptions for addictive painkillers, and that they are also doing more to monitor doctors’ prescribing patterns and to catch abuse by patients. Several insurers said they had seen declines in monthly opioid prescriptions, a sign of progress.
But their behavior has infuriated many patients, who say they want to avoid taking opioids if possible. They argue that insurers are too focused on a drug’s cost, since many of the painkillers with a lower risk of addiction are more expensive.
Our project examining high drug costs is not over. We are already digging into other corners of the prescription drug world, hoping to shed light on more of the hidden forces that are keeping drug costs high. Stay tuned, as well, for more stories that were inspired by our readers.
Have you had trouble paying for prescription drugs? Tell us about it at http://ift.tt/2tFIfKR or at this link.
Continue reading the main story Source: http://ift.tt/2xr1g7O
0 comments:
Post a Comment