Sure, it is scheduled, but the approval isn’t there. I received a call the other day from the insurance company that the expedited review has been denied. So I called the insurance company. I was told that the infusion was still under review. Under review for what??? When I tried to get Rituxan approved, the denial was because Rituxan wasn’t a FDA approved drug for multiple sclerosis. The denial letter went on to tell me based on my history that I still haven’t tried; Tecfidera, Lemtrada, Aubagio, Extavia, Zinbryta, or Novantrone. So what is the hold up approving Ocrevus. The insurance has had the information for a week at least. My medical history is all there. I’m followed by one of the insurance companies nurses each year because I’m a long-term care, state aided case on disability. Why does it always have to be so difficult?
I moved from Rituxan, which I would have preferred to stay on, because of the issues with insurance. The medicine would be covered by the Rituxan assistance program but the infusion wouldn’t. This was the main reason I decided to switch to Ocrevus. Personally I’d rather have stayed on Rituxan, which is Ocrevus minus a few parts, because this drug has been around for 15 years. There is a history with it and to me that spells S A F E T Y. However I discussed it with my doctor and my family and said, how could they deny it now it’s approved by the FDA. Yet here I am a little over a week away from the infusion date and insurance has yet to approve.
My infusion was technically due July 17 so already I’m a few weeks back, if I hit an appeal because of a denial, I’m going to be at least a month out. That is certainly my biggest fear. I just can’t understand how this could possibly be denied, but I put nothing past my insurance. My saga continues with changing to Ocrevus….