RN forced to try meds known-to-fail for 12 months
Congressional District: CA41
Cancer, Chronic Pain, Skin Disease
Issues and Challenges
Jennifer has encountered: Access to Medicine, Copay Issues, Insurance Issues, Caregiving, Copay Accumulator, Disability, Invisible Illness, Prior Authorization, Step-Therapy / Fail First
My name is Jennifer Pellegrin and I am a registered nurse from Riverside, California. I live with psoriasis and psoriatic arthritis – a chronic, inflammatory disease that has no cure. Psoriatic disease is complicated to treat and I have to work with both a dermatologist and rheumatologist.
In 2018, my health care team and I determined a biologic would work best for me. However, I was devastated when my insurance company forced me to try and fail three different medications first.
I’d like to share my step therapy story with you:
First, my insurance company made me try and fail topical creams for 3 months, even though I had already used them for years with no results.
Then the insurance company attempted to force me into trying a medication that would cause life-threatening damage to my liver. After three months of medical documentation to show this risk, they finally allowed me to bypass this step.
The third and final hoop the insurance company made me jump through made my symptoms even worse. So, I’m used to having the red, flakey, painful psoriasis patches on my body, but the step therapy treatment forced by my insurance exacerbated my psoriasis so bad that in just one month it covered 90%of my body. The insurance company said I still had to stay on this treatment for two more months to prove “failure”.
Finally, after a full year, the insurance company approved that biologic originally prescribed by my doctors. 12 calendar months of fighting the insurance company and “trying and failing” medications that my doctors knew would not work. Yet, in just three weeks on the originally prescribed biologic, the patches were gone, my joint pain was manageable – and for the first time, I felt the relief I had been hoping for.
My Motivation and Inspiration
That those in future generations don't have to fight the battle that affects those battling these diseases and that advocating and raising awareness allows for more compassion and empathy from those who don't know the battle.