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Letter: New law protects patients



Last modified: Sunday, September 28, 2014
Prescribing medicines requires extensive medical training, clinical experience and direct knowledge of a patient’s personal medical history, all of which is best understood by a patient’s own health care provider.

But that doesn’t stop insurers from trying to interfere. I should know. I’ve been battling health insurers almost as long as I’ve been battling pain – nearly 12 years.

Yet, insurers still find ways to astonish me with schemes that put dollars over patient health. Luckily for residents of New Hampshire, a new law goes into effect this month (SB 91) that will help protect patients from an especially egregious cost-containment practice: forced off-label prescribing.

Forced off-label prescribing occurs when insurers require that patients try and fail on one or more prescription medicines that are not approved by the Food and Drug Administration for the treatment of their medical condition before granting access to those that are. Insurers require this extra step not because the off-label treatment is better, but because it is cheaper.

New Hampshire’s new law protects patients living with pain and other medical conditions by putting restrictions around this practice.

Of course, off-label medicines are often the best option for patients. Just ask anyone living with cancer or an autoimmune disorder.

The new law also limits insurers’ ability to refuse coverage for off-label use when prescribed by a health care provider. The bottom line is this: Providers must have the discretion to prescribe the medicines that are best for their patients, not an insurer’s balance sheet.

PAUL GILENO

Middletown, Conn.



(The writer is CEO of the U.S. Pain Foundation in Connecticut.)