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MS Patient's Life-Saving Drug Battle
20 Nov
Summary
- Serena Hostvet battled insurance for a $78,858/year MS drug.
- Cheaper MS drugs caused severe side effects for Hostvet.
- Two-month delay in treatment caused Hostvet significant stress.
Serena Hostvet, a 43-year-old artist from Wisconsin, has relapsing-remitting multiple sclerosis (RRMS), a condition causing debilitating symptoms like shaky hands and vision problems. Her fight for treatment highlights the challenges of "step therapy," where insurers mandate trying less expensive drugs first. Hostvet experienced severe flushing and gastrointestinal issues with one medication and vision loss with another, prompting her doctors to seek approval for Ocrevus, an infusion therapy costing nearly $79,000 annually.
Her insurance provider, Anthem Blue Cross, initially denied coverage twice, despite her doctor's appeals. This led to a nearly two-month delay in receiving the necessary treatment, a period that Hostvet described as immensely stressful. Such delays can exacerbate MS symptoms and potentially lead to permanent damage, according to experts from the National Multiple Sclerosis Society.
After significant back-and-forth, Anthem Blue Cross eventually verified Hostvet's treatment history and approved Ocrevus, which she finally received. While this marks a relief, the ordeal underscores the broader issues of access to costly medications and the arduous process patients face when insurance companies dictate treatment pathways.
