Andrea Kelley's story is one that should alarm every American. After a year of stability on her cancer medication, United Healthcare is now denying her access to Lupron injection and Vioza. Her doctor prescribed these treatments. They're working. And now an insurance company is stepping between Andrea and the medicine keeping her cancer at bay.
"When a patient who has faithfully paid insurance premiums is denied access to the treatment that could save their life, that is a betrayal of healthcare's fundamental promise," said Terry Wilcox, Co-Founder and Chief Mission Officer at Patients Rising. "Andrea's case isn't an isolated incident. It's part of a pattern where insurers override doctors and patients pay the price with their lives."
On Thursday, Andrea's case became a focal point during a congressional hearing before the U.S. House Ways and Means Committee. Lawmakers questioned top health insurance executives about the role of Pharmacy Benefit Managers, the middlemen who manage prescription drug benefits and often stand between patients and their medications.
Rep. Buddy Carter of Georgia brought Andrea's case directly to the insurance executives: "Despite being stable on the medication for a year, United Healthcare is now denying Andrea her Lupron injection and Vioza medication, according to her doctor. These denials are actively increasing Andrea's chance of cancer recurrence. This isn't about convenience or cost. This is about whether her cancer comes back."
The hearing comes as Congress considers bipartisan reforms to address PBM practices, though significant hurdles remain. For Andrea and thousands of patients like her, those reforms can't come soon enough.
Read the full story at WDRB: Louisville woman's denied cancer medication highlighted in congressional hearing