Frustrated

[jiml]

Saturday I received a denial letter for Enbrel through the new pharmacy services prior authorization department that our insurance goes through. Saying that the practitioner or pharmacist has reviewed the information provided by my dermatologist. They denied it due to their prior authorization policy specific to my condition. That I did not fulfill step therapy. That I should only be on Enbrel after I try Humira and it failure to help...... I am so pissed. What gives them the right to say what treatment I should be doing. When they haven't seen me or my medical records from my dermatologist for the last 23 years to know what medicines I have been on. I have been on Enbrel for the last ten years. Just wondering if I have to go through all the treatment steps in the policy. That is just crazy. My dermatologist has now prescribe me Humira. So I am waiting to see if their prior authorization department will approve it. I don't know how long that would take.

Hi Sarah
What a bloody shame that they are asking you to go back to square one have you tried the route of asking Enbrel to fight your corner
have you contacted Enbrel on their website where they offer help and support for clients that are refused Fred pointed me at these sites regarding another members problems.... However it may be a route you have already investigated if not go to this postEnbrel (etanercept) at the bottom is a link to their website, and a button for help with finance. They may offer help with the difference in cost rather than lose a client
I would say it's worth a shot