Health insurance companies stand between doctors and their patients: it’s a crisis that demands immediate attention and action. My family is currently experiencing this nightmare with our insurance company, Regence BlueCross BlueShield of Utah, denying coverage for a life-saving cancer drug, Perjeta (pertuzumab), for my wife’s breast cancer treatment at Huntsman Cancer Institute.
Perjeta is fully FDA approved for this specific condition and protocol. It was prescribed by our board-certified oncologist, a specialist in breast medical oncology. This treatment follows clinical standards of care and all guidelines established by respected organizations such as NCCN, ASCO and NICE. Despite this, our insurance company denies coverage, claiming the drug is “experimental” and the benefits are unknown. This is in direct contradiction to the clinical trials they cite, FDA approval, and global expert consensus.
This absurd struggle is more than a bureaucratic inconvenience; it’s a matter of life and death. The cost of Perjeta could easily exceed $160,000 over the next six months if we have to pay out of pocket. How can you fight against an insurance company that refuses to see reality as it is? This rejects and disregards the standard of care? Does this neglect a doctor’s prescription and comprehensive industry care guidelines? The current system leaves patients stuck in a crawl space, unable to access the treatments they desperately need.
It’s not just about our history; It’s the story of many Utahns who find themselves saddled with faceless insurance companies instead of focusing on recovery. The system must change. We need a universal health care system and we will need it quickly. The longer we wait, the more Americans’ health will decline under this unjust, unjust, and inhumane system.
Bryce Haymond, Lehi