While we were requesting approval from the insurance company, I contacted Eli Lilly and Co., the company that developed ixekizumab, to request any information it might have regarding ixekizumab approval for psoriatic arthritis. Eli Lilly representatives said ixekizumab was not approved for psoriatic arthritis treatment. I told them their drug was being proposed and imposed by the insurance company for psoriatic arthritis, and they didn’t react to that other than sending me data from the SPIRIT studies. I asked whether they could send representatives to explain their strategy. Their answer was clear: They weren’t visiting rheumatology practices because ixekizumab was approved for dermatological conditions only.
Ixekizumab wasn’t even FDA approved to treat the patient’s condition at the time!
Final Thoughts
I’m writing this column to raise awareness and call for more oversight and transparency when it comes to insurance companies and drug coverage. I strongly believe patients shouldn’t be exposed to different biological agents unless it is medically indicated.
The exorbitant costs of such medications as secukinumab make it difficult for patients to retain freedom of choice and say no to insurance companies when they’re bullied. Changing insurance companies may sound like a solution, but it’s much more difficult for patients with chronic conditions requiring such medications to change insurers.
Bottom line: Once an insurance company commits to a patient by approving medication coverage, changing that commitment for financial reasons is nothing short of failure.
Roy Souaid, MD, is a second-year resident in internal medicine at Brown University. He is interested in patients first, as well as healthcare policy.
Editor’s note: This article expresses the opinions of the author and doesn’t necessarily represent the views of the editors or the ACR.
A Call to Action
The ACR is actively working to help prevent medically unnecessary switching and has placed this issue on its list of priorities for 2018. You can help. Visit the Legislative Action Center to learn how easy it is to become an advocate for rheumatology issues, practices and patients. U.S. members can also contribute to RheumPAC, the ACR’s nonpartisan lobbying arm.
