this post was submitted on 20 Dec 2023
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Dr. Erinn Maury knew Remicade wasn't the right drug for Patti Schulte, a rheumatoid arthritis patient the physician saw at her Millersville, Maryland, practice. Schulte's swollen, painful joints hadn't responded to Enbrel or Humira, two drugs in the same class.

But the insurer insisted, so Schulte went on Remicade. It didn't work either.

What's more, Schulte suffered a severe allergic reaction to the infusion therapy, requiring a heavy dose of prednisone, a steroid with grave side effects if used at high doses for too long.

After 18 months, her insurer finally approved Maury's drug of choice, Orencia. By then, Schulte's vertebrae, weakened by prednisone, had started cracking. She was only 60.

Schulte's story of pain, drug-hopping, and insurance meddling is all too common among patients with rheumatoid arthritis, who often cycle agonizingly through half a dozen drugs in search of one that provides a measure of relief. It's also a story of how doctors are steered by pharmacy benefit managers — the middlemen of the drug market — as well as by insurers.

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[–] Chetzemoka@startrek.website 2 points 11 months ago* (last edited 11 months ago) (1 children)

I'm just quoting what's actually in the news article, which I didn't find to be sensationalist at all.

[–] themeatbridge@lemmy.world 1 points 11 months ago (1 children)

Ok, I'll quote whats in the article and what I found to be sensationalist.

Dr. Erinn Maury knew Remicade wasn't the right drug for Patti Schulte,

No, she didn't. She may have believed, or expected, or felt that Remicade wasn't the right drug, but she didn't know.

a rheumatoid arthritis patient the physician saw at her Millersville, Maryland, practice. Schulte's swollen, painful joints hadn't responded to Enbrel or Humira, two drugs in the same class.

Implies that patients who don't reapond to those two drugs won't respond to Remicade because it's in the same class of drugs. This is simply not true. It's possible, you could even say likely, but it isn't a guarantee.

But the insurer insisted, so Schulte went on Remicade. It didn't work either.

What's more, Schulte suffered a severe allergic reaction to the infusion therapy, requiring a heavy dose of prednisone, a steroid with grave side effects if used at high doses for too long.

How could anyone have predicted an allergic reaction to the infusion? Also, Orencia is available as an infusion as well. The patient could have also suffered an alergic reaction to Orencia. This is simply an unfortunate event that really has nothing to do with the insurance company or choice of drug. It just makes you feel sorry for the patient, which is just emotional manipulation.

After 18 months, her insurer finally approved Maury's drug of choice, Orencia. By then, Schulte's vertebrae, weakened by prednisone, had started cracking. She was only 60.

Prednisone is often prescribed for RA patients for a variety of reasons. Prednisone is known to deplete calcium among other nutrients, and calcium levels should be closely monitored when prescribed to women over 40.

It's not the insurer's fault that her vertebrae are cracking, nor can we know that her vertebrae wouldn't be cracking on Orencia. Again, this information presents Orencia as a solution that could have prevented this, when we don't know that's true and it's irrelevant to the actual problem anyway. Sensationalization.

Schulte's story of pain, drug-hopping, and insurance meddling is all too common among patients with rheumatoid arthritis, who often cycle agonizingly through half a dozen drugs in search of one that provides a measure of relief.

Pain and drug hopping is just the story of every RA patient. It's my story, too, and as previously mentioned, I have the good insurance that doesn't meddle in my treatment. "Cycling through half a dozen drugs in search of one that provides relief" is just the reality of treating autoimmune-related arthritis (not to mention several other illnesses). It's like doing an article about referees fixing baseball games, and then complaining that these unfortunate players have to run all the way around the diamond, touching every base in sequence, because of these shitty refs. No, that's just baseball. Shitty refs are a problem, but the players are not victims of the refs because they have to play baseball.

It's also a story of how doctors are steered by pharmacy benefit managers — the middlemen of the drug market — as well as by insurers.

This is the thesis of the article, and ought to be the focus, supported by facts. A doctor chose a treatment for their patient, supported by clinical evidence, and the treatment was delayed because the insurance company wanted to try something else first. That's a fucking horror story by itself. It doesn't need window dressing. It would have still been bad if Remicade had been effective or Orencia had caused an allergic reaction because insurers shouldn't meddle in healthcare decisions due to their conflict of interest. Hell, they should exist at all if we're looking to fix things.

[–] Chetzemoka@startrek.website 2 points 11 months ago

I don't find this sensationalist. I find it narrative for members of the public who don't know about this kind of medical care.