Your recent editorial on the cost of care really hit home for me as the mother of a 22-year-old with a seizure disorder. My daughter has been taking two generic anti-epileptic drugs for her condition, as was approved by HMO. After being seizure-free for years, she had a seizure recently while riding her bicycle, and tests in the ER showed her medication blood levels were low. We learned from her neurologist that generics generally work poorly for seizure disorder, but many health insurers deny brand name drugs anyway due to the cost, even if the doctor specifies ‘no substitutes.’ This leaves the patient with the choice of the often-ineffective generic or paying out-of-pocket for the brand-name drug. Usually there is no appeal policy, so the patient is stuck.
—Holly T. Tyler
Santa Cruz, CA