By Roseannette Lopez

Our health care system is among the best in the world. It has kept my fifteen-year-old son alive (I’m not giving his name to protect his privacy). He has hemophilia, a disease he was born with. Hemophilia is a blood disease where the blood does not clot normally. To stay alive, you need medicine. Without it, you will die. Even with it, the disease causes chronic pain and internal bleeding, making normal life difficult. You must find the right medicine to lead even close to a normal life.

However, finding the right medicine to treat hemophiliacs is not always easy, as each case is different. And while the right medicine is available for my son, that medicine is not always easy for patients to get. The problem is something called Step Therapy. It’s where the insurance companies require you to try one, or several, medicines first before they will approve the one that works. It makes you take several “steps” before you get the medicine you want, and the medicine your doctor wants.

Patients are forced to go through painful failures on medicines not prescribed by their doctors just so the insurance companies can save money. Think about it. You arrive at the pharmacist to get the proper medicine prescribed by your doctor, and the pharmacist tells you you can’t have it because the insurance company wants to you fail first on another medicine. That’s why step therapy is also called “fail first.”

My son has been required to “fail first” by taking a plasma-based drug therapy before he can get the right drug. He has to insert a large needle into his arm every day. He has developed a hip bleed and he is showing signs of new arthritis. In addition, the medicine he is forced to take has not been as effective in treating the hemophilia. My son is not a human guinea pig. He should not be forced into a painful therapy with awful side effects because the insurance company wants us to “fail first.”

And if you are wondering if this is common, 69% of health plans in the U.S. use Step Therapy, meaning it could change your life if you ever need life-saving or life-enhancing drug treatment for such diseases as Alzheimer’s, cancer, diabetes, epilepsy, or many others.

I have asked the insurance company to allow for my son to get the right drug therapy. It would allow him better results for the hemophilia and fewer side effects. We sent in a request to the insurance company and then we started getting denial letters. The denials came because of the additional costs.

However, studies have shown that when patients are forced to fail first, the process ends up costing more in the long run because of the side effects and hospitalizations. It just doesn’t make sense to force patients to suffer because the insurance companies are being penny-wise, pound-foolish.

The process called Step Therapy leaves my son, and patients around the country, vulnerable and unprotected. It’s not right to do that to human beings who just want to get well and live a productive life, like my son.

In many states across the county, laws have taken effect to stop therapy or take measures to ease the ill effects on patients. Texas has such a law, as well as California, New York, Connecticut, Louisiana, and many others. It may be time for New Mexico to consider protecting its people from the health care failures called Step Therapy.

Roseannette Lopez is the mother of a 15-year-old boy with hemophilia. She lives in Albuquerque, NM.

Live from Silver City

Join GCB Three Times Weekly Updates

Welcome to Three Times Weekly Updates! You will be subscribed to email notifications with links to recently posted articles.
You can unsubscribe anytime. We never share or rent your email to anyone.

Fire Alerts

Editor's Note

Those new to providing news releases to the Beat are asked to please check out submission guidelines at http://www.grantcountybeat.com/about/submissions They are for your information to make life easier on the readers, as well as the editor.

Welcome to our new version of classified ads.  We invite you our readers to post your own classifieds, which are available for viewing 24/7 and are very reasonable in price.

We have received complaints about large images blocking parts of other articles. If you encounter this problem, click on the title of the article you want to read and it will take you to that article's page, which shows only that article without any intruders. It's a software problem, not easily fixable, other than showing fewer articles per summary page. If you are a frequent visitor, you might not mind fewer articles per page, but if you only come once in a while, you likely want to see more articles to browse. Write me at editor@grantcountybeat.com to let me know your feelings on this issue. 

Because you are an esteemed member of The Grant County Beat readership, be assured that we at the Beat continue to do everything we can to be in full compliance with GDPR and pertinent US law, so that the information you have chosen to give to us cannot be compromised. 

The Grant County Beat endeavors to post to the Elections page, under News, at the least, notices of candidates for Grant County races. Some candidates for statewide races have also sent their notices. 

The Beat continues to bring you new columnists.Recent additions  include the Christian Corner, for those who are already Christians or are exploring the beliefs.

The second is a business-centered column—Your Business Connection by the New Mexico Business Coalition. The group works to make policy in the state of New Mexico better for all businesses, large and small.

The Beat has a column for you gardeners out there. The Grant County Extension Service will bring you monthly columns on gardening issues. The first one posted is on Winterizing your houseplants and patio plants.

The Beat totally appreciates its readers and subscribers!  


All articles and photos indicated by a byline are copyrighted to the author or photographer. You may not use any information found within the articles without asking permission AND giving attribution to the source. Photos can be requested and may incur a nominal fee for use personally or commercially.

Don't forget to tell advertisers that you saw their ad on the Beat.

Feel free to notify editor@grantcountybeat.com, if you notice any problems on the site. Your convenience is my desire for the Beat.

If you subscribe to the Join GCB Three Times Weekly Updates option on the left side of this page, you will be subscribed to email notifications with links to recently posted articles.

It's really easy to check to see if there's a classified ad. Just click on Classifieds in the blue menu and the page will open letting you know if there is a classified ad. Remember that your buying classified ads gives you a wide readership, as well as supporting the Beat. Post YOURS for quick results!

Note that if an article does not have a byline, it was sent to the Beat and written by someone not affiliated with the Beat

When you click on the blue and orange button on the upper left side of most pages, you will find out how you can help the Beat defray its expenses, which, with increased readership, continue to grow. You will arrive at a page that gives you options of how you can Help the Beat. All help is greatly appreciated and keeps the news you want and need coming into your browser.

Consider the Beat your DAILY newspaper for up-to-date information about Grant County. It's at your fingertips! One Click to Local News.

Thanks for your support for and your readership of Grant County's online news source—www.grantcountybeat.com