What a pill

Last week my onco doc prescribed new meds … two different pills to take each day.  The pharmacy at Dana Farber could have filled the Rx that day, Wednesday, but NOPE, my health insurance requires the meds be filled by their ‘specialty’ pharmacy.  The prescription was sent to them.  I called  the specialty pharmacy the next day, Thursday, to check, and they said, oh yes, we have the prescription — just have to ‘process’ it, hopefully by the end of the day.  Okay, I’m thinking, they can overnight the meds so I can start Friday!  NOPE.  Friday morning still ‘processing’ the order.  Well okay, if they overnight the pills for Saturday delivery I can start then.  NOPE, by end of Friday, still ‘processing’.  That of course brought me to Monday — I called the specialty pharmacy twice and my insurance company three times.  Hours on the phone, mostly on hold.  NOPE.  “Still processing.  It’s in the cost overrun department now.”  My mind is spinning  …  scans showed my cancer is spreading and growing … and insurance is ‘processing’ my prescription?  I’m picturing weeks of my life slipping off a timeline.  It was not until Tuesday afternoon that I got the call saying the meds would be delivered the next day, one week after I could  have picked them up at Dana Farber.

Why all  of this?  One medicine is insanely expensive, $12,000 per month.  Yep, my onco doc said it costs $144k per year.  How do drug prices like this even exist?  And the ridiculous price tag makes me pause.  Do I deserve this drug?  Is my life worth prolonging?  Real questions.  Then I remember the drug is intended for women like me, my age roughly, my life expectancy.  If I’m not worthy then who is?  (phew)

But why the delay in getting the medicine?  I imagine someone at the insurance company running numbers and finding that if each woman needing this medicine is delayed by one week, they would save X number of dollars per year.  Go ahead, call me a skeptic!  My anxious week of waiting was frustrating and demoralizing.  So I came up with a plan.  If insurers actually are delaying/preventing access to needed medicine, I would have no qualms about changing my living will (advance directive) to state that I want all means used to prolong my life when I am near the end.  I have thought that spending tens of thousands of dollars to keep an almost dead person alive is a waste, but if insurers are not playing a clean game, then insured people could ‘encourage’ better behavior.

The meds arrived Wednesday, early!  UPS woke me up, but that was okay.  My anxiety evaporated.  I opened the box … packaged prominently with the meds were three boxes of anti diarrhea pills.  Yikes.  I was told that diarrhea is a common side effect, but this packaging was unexpected.  My poor GI — for the last few months on the chemo, constipation was a side effect and  ‘loosening’ pills were prescribed.  Now the opposite?  My GI is going to be so confused.   Hang in there large intestine!

What a pill.



3 Replies to “What a pill”

  1. Kaki – more evidence of the brokenness of our health care system. Why is it that we as humans can’t just do the right thing by each other. I had the opposite experience when my aunt Phyllis was on her death bed, with an advanced directive to do nothing, and the day before she died the facility ran thousands of dollars worth of un-needed, un-requested tests, just to make extra insurance money. Who knows if they even ran the tests, and if they did, all they did was torture my aunt. If we all just clean up our act and do the right thing, then people like you will get the care they need, and people like my aunt will be left alone. I truly believe that allowing the profit incentive to drive health care is dangerous and so often in-human. I am sorry that you had to go through that. I am happy that you have health care and a good Onco doc. Everyday of life is precious, and everyday I am glad you are here! I love you!

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