State drug panel can help pa­tients

Los Angeles Times - - OPINION -

Re “Drug pric­ing sys­tem is bro­ken,” Col­umn, June 21

Pa­tient Jane Blu­men­feld’s law­suit over An­them Blue Cross’ re­fusal to pay for the out­ra­geously ex­pen­sive hep­ati­tis C drug Har­voni may re­sult in her get­ting the drug in a year or two. But she can ap­peal An­them’s de­ci­sion to the Cal­i­for­nia Depart­ment of Man­aged Health Care, which would make its de­ci­sion within 30 days af­ter get­ting her med­i­cal records. It refers the mat­ter to three doc­tors ( spe­cial­ists who re­main anony­mous), who de­cide if the treat­ment is more ben­e­fi­cial than the al­ter­na­tives.

When An­them re­fused to au­tho­rize Har­voni for my hep­ati­tis C be­cause I was not yet at death’s door, I ap­pealed to that depart­ment, which ruled in my fa­vor in 30 days. The in­surer, which can­not ap­peal, was or­dered to au­tho­rize the Har­voni within five busi­ness days. Af­ter tak­ing the drug for eight weeks, I was cured.

Some say, “I don’t want the gov­ern­ment com­ing be­tween my doc­tor and me.” I don’t want a greedy drug maker or an in­sur­ance com­pany com­ing be­tween us.

Bruce Janger

Santa Mon­ica

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