GUEST COLUMN: Physicians and patients — not bureaucrats — know best

Published: Thursday, February 6, 2014 at 04:50 AM.

Health care professionals have the expertise to know what is best for patients, and must have access to a full range of therapeutic options to use as they see fit.

They should not be burdened with administrative obstacles as they seek the most appropriate therapy. Health care professionals, not bureaucrats, should determine the best course of treatment and medications for their patients. 

I have been prescribed Victoza to treat Type II diabetes. Upon transfer to a new insurance company, I couldn't obtain a refill in a timely manner due to their determination that this medication needed pre-authorization. I couldn't afford the medication, and couldn't purchase it and wait for reimbursement, which left me with no medication for two weeks. A few months later, I attempted to obtain a refill and was told another pre-authorization was required.

Pre-authorization for medication, especially when it has already been in use, is not a sensible use of health care dollars. 

Balance is needed. Policies must not only take into account immediate costs, but also recognize that proper, early treatment of a disease can ward off future, more costly treatments such as hospitalization. When a physician prescribes medication, the insurer should not be able to refuse to cover that prescription until a patient tries and fails on a cheaper alternative not prescribed by the doctor.

We need to seize the opportunity this legislative session to ensure that our system sets the standard for continuity of care, formulary requirements and access to medicines and therapy.

Many Floridians face barriers to care when dealing with their health. We should focus on making it easier for people to care for their health, removing unnecessary obstacles that could deter patients from following necessary and cost-saving drug therapies.

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