Patients are being denied access to life-saving medicines – even when their doctors prescribe them. Learn more about who is driving these underhanded tactics and business practices, and how to navigate Rx access restrictions.
Check out the resources below:
New Polling: Patients and Providers Oppose Prior Authorization Policies Imposed by Insurers and PBMs
A recent national poll commissioned by Let My Doctors Decide found that a majority of health care consumers oppose prior authorization policies imposed by health insurance companies and pharmacy benefit managers (PBMs), which often result in access restrictions, increased patient costs, and delayed health and wellness. Related research of rheumatology providers in several states found significant delays in the vast majority of prior authorization decisions requests as a result of insurance company and PBM requirements.
Health Insurance Access Barriers: A National Scorecard
A new national scorecard from Let My Doctors Decide examines three common types of medication access barriers that patients often encounter with their health insurers: restrictive formulary placement, step therapy, and prior authorization. The study focuses on medication coverage for patients living with the following autoimmune diseases: Crohn’s disease, lupus nephritis, multiple sclerosis, psoriasis, psoriatic arthritis, rheumatoid arthritis, and ulcerative colitis. The analysis found that health insurance plans receive poor grades across the board when it comes to ensuring patients living with autoimmune diseases can access the medications used to manage their conditions.
Middlemen Squarely in the Middle of the Doctor-Patient Relationship
The Harmful Impacts of Access Restrictions
Patient Guides
Our patient guides offer tips and advice in navigating processes that put your health at risk, undermine your doctor’s expertise, and cause significant financial waste in our health care system.
Step Therapy Explained: Carly’s Story
Meet Carly, a woman who was diagnosed with Crohn's disease and forced to endure step therapy. Because of the policy, Carly had to wait several months before she could the medicine her doctor prescribed.
Step Therapy Activation Kit
Track Your Progress
Click below to access printable sheets you can use to track your medication use, symptoms, visits to the doctor, and your doctor's answers about new prescriptions.
Appeals Letters
Insurance policies are often dense and overwhelming. Click the button below to learn more about the insurance appeals process and access sample appeals letters.
Get Involved
Want to make your voice heard? Want to share information on step therapy with your friends and family? Click below to discover shareable content on the realities of step therapy.
Poll Results
A recent poll conducted by Lake Research Partners found that seven out of 10 Michigan consumers have an unfavorable view of step therapy. Ninety-eight percent of these consumers believe that doctors rather than insurance companies should have the final say when it comes to treating a patient with an autoimmune disease. Click below to view the full poll results.