So this is a gross understatement. Insurance companies would rather have you die a slow painful death then treat you for a chronic illness. Aetna is the absolute worst and have made my diagnoses 10 times harder than it ever needed to be. It is a business, and they treat you as such. If you are expensive they will go to great lengths to prevent you from proper medication. I was denied Tysabri three times. Aetna called it experimental despite its FDA approval. I had to try a drug that wouldn’t even help me and have a terrible allergic reaction to prove I needed the better drug. Aetna claimed I needed to fail another drug first. A drug called C0paxone with mediocre efficacy at best. I took one dose of this and felt like I couldn’t breath, had all over hives, was shaking, stomach upset…etc. The only positive is that I had a allergic reaction. The drug maker of that drug did not recommend further treatment due to intolerance.
We filed an appeal for Tysabri with the State of California. A win with the state would require Aetna to pay for the drug whether they like it or not despite their denials. It was a lot of work. I pulled clinical trial data along with as much information I could find on cost comparisons…etc. The letters from doctors and personal plea from myself paid off and we won the appeal. I finally felt like I could begin really fighting this thing!
Jennie's MS Journey 