Patient Access of Florida

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Florida Times Union: Lead Letter: Florida must show more humanity toward patients in pain

Proposed Florida legislation could help save patients from months without medication

Legislators have the opportunity to address fail-first insurance protocols that prevent patients like me from receiving medication in a timely manner.

I have been treated like a number.

Fail-first or step-therapy protocols require a patient to try the least expensive treatment or medication to address a problem despite what a patient’s physician recommends.

After failing first on the least expensive option, patients can then receive the medication and at the doses their physicians originally prescribed. These protocols force many patients’ conditions to deteriorate.

I have suffered from schizophrenia and bipolar disorder for more than 40 years, and have dealt with a history of suicide and emerging mental illness with improper medications.

For many years, I have struggled to receive the proper medications that I need.

I failed on more than 30 medications before finding two that work.

As a dual-eligible Medicaid patient, I was transferred to a Medicare Part D plan and was told that there would be no restrictions on my medications. Immediately after being transferred to Medicare Part D, I was faced with barriers and repeated denials.

This continued for more than 50 denials despite the appeals made by my physician, who noted the dangerous side effects from the cheaper dose levels suggested due to fail-first protocols.

After months of fighting the battle alongside my doctors, I was finally approved for the proper medication.

We must ensure that patients aren’t subjected to complicated processes to receive necessary medications.

The current legislation, House Bill 863 by Rep. Shawn Harrison and Senate Bill 784 by President Don Gaetz, can help to address these problems.

Our representatives need to capitalize on the opportunity of this legislative session to protect Florida’s patients and help guarantee that patients have access to proper medication.

Patients need the right medicine at the right doses at the most appropriate time to ensure the best and most efficient course of treatment.

Peggy Symons, member

National Alliance on Mental Illness of Greater Orlando

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