Brannen's StoryAdvocacy Story
It’s hard to put into words the heartbreak you feel, helplessly watching your child suffer excruciating pain day-after-day. We were beyond relieved when our son, Brannen, began taking a medication that finally worked to treat his ulcerative colitis. Then a letter arrived from our insurer stating he had to quit taking it. We soon came to understand we were just one more family being subjected to insurance-mandated step therapy.
All we could think as we read that letter was, “You must not have a clue what this kid is going through.” Step therapy, or fail first, is an insurance protocol that requires patients to try one or more insurance-preferred medications before “stepping up” to one they and their doctors think has a better chance for success. Step therapy can be especially harmful for people like Brannen who have a chronic, progressive inflammatory bowel disease (IBD). Waiting months, or sometimes years, to get on the right medication can lead to irreversible damage.
In Brannen’s case, step therapy seemed absolutely ludicrous. The thing is, he had already tried and failed the medications on our insurer’s list. When Brannen was diagnosed at age four, we and his doctor had hoped that a less aggressive treatment would work. Our insurance company had approved every medication Brannen had tried—and they wanted him to take them again?
After 10 months of trying different medications, Brannen was finally on the right one. He was back to his energetic, happy self, and was able to return to kindergarten. We figured our insurance company must have made a mistake. But then they denied our appeal.
We couldn’t imagine letting Brannen suffer such pain again, or the anxiety from not knowing when or where his symptoms would strike. So, we kept fighting. After countless hours on the phone with our insurer, we eventually applied for and received a temporary, and then permanent, step therapy exemption so Brannen could stay on his medication.
Brannen’s almost nine now. He’s been on the same medication for three years and is doing great, practically symptom free. Like us, Brannen hates knowing that other kids can’t get the treatment that will make them feel better because they must try and fail other medications first. He joined us and the Crohn’s & Colitis Foundation to advocate (successfully) for Georgia to enact a step therapy reform law. Now we’re calling on the U.S. Congress to do the same, so that all patients with private insurance have access to an expedient and medically reasonable appeals process.
Learn more at www.crohnscolitisfoundation.org/steptherapy.
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