Two newborn twins need a one-dose treatment that would save their lives: Zolgensma, a $2.1M drug. Insurance (also the mother's employer) cut coverage of the drug the day after they were born.

I'm not sure what's worse, the insurance was cut or that a life saving drug is 2.1 million?!

We have children who need help! Someone call in the "pro-life" conservatives! Don't worry, gang, we know those God-loving righteous people will come through to solve this. Surely, they will be stumbling over each other help. Nobody talks a bigger game of saving the kids.

Important facts for people that didn’t bother to read the article: it’s $2.1m each, so total is $4.2m. The coverage of the drug was cut on a schedule that was determined in January. The diagnosis of the disease was 5 days after the cut.

The cost isn’t an issue in my mind, but I think good to know how much the parents are in for. Insurance companies exist because of these costs, they should have to cover any treatment that has significantly higher success rates, especially when the lack of coverage will result in death, or other life-long consequences.

The timing and schedule are important as the headline makes it appear this decision was in response to these kids being born with the condition, when in fact, there was no diagnosis at the time of the cut and these kids were still months away from being born when the decision was made.

Final bit, though this wasn’t in the article, the drug is being covered for these kids. It took pressure from the state government apparently, or maybe just all the bad press. Shouldn’t change anyone’s opinion on POS insurers, but it’s at least good news that these kids aren’t condemned to a death sentence.

Interesting how insurance companies demand restrictions to "special enrollment" periods or specified times to begin coverage. It's a tactic to prevent people from beginning coverage before taking on significant healthcare costs and then cancelling after their treatment is finished.

But yet, an insurance company is able to change coverage without following similar practices? Is just about as close to a bait and switch as you can get.

Where's all the pro-life people and their wallets now?

What are the bad faith laws in the US like? In my province (BC) here in Canada the courts would publicly flay you for such blatant bad faith coverage. When I worked in insurance we had regular seminars with the lawyers on bad faith; the punitive damages can be (intentionally) ruinous to insurers.

What’s most pathetic is the scale. $2.1 million may seem like a lot for a single use drug, but that $2.1 mil loss dissipated out to shareholders probably isn’t so much. I don’t have the exact numbers but I’ll bet the loss of revenue isn’t even a blip to the average shareholder income.

They’re killing newborns based for what amounts to nothing to them. It’s sick.

Well thank god we don't have any Death Panels from Obamacare though!

Nother example of how much care for babies exists after theyre born

Your life ain't worth a thing until you make money for the rich.

In a statement, Chief Executive Officer Mike Poore told KCTV5:

“Global pharmaceutical companies are putting profitability over affordability, making it impossible for employers like our hospital system to bear the financial burden of these exorbitant drug prices.

In January 2024, Mosaic’s Health Care Trustees made the gut-wrenching decision not to cover expensive gene therapy used to treat ultra-rare diseases. Covering these treatments could cripple the financial viability of our health system, directly impacting our more than 4,000 employees and the approximately 270,000 people who rely on the health care we provide in small communities across four states.

We are working hard to help find alternative solutions and financial resources to help in this case. Bottom line: Families should not have to focus on the astronomical costs imposed by drug companies, but instead should be able to focus on the care of their children in a medical crisis.”

wow it's almost like it's a shitty fucking system and you're very much a part of it.

from his linkedin:

"Mike is one of the finest men with whom I have ever worked. He relates well to and inspires his employees. He demands high quality while keeping his eye firmly on the bottom line. I would follow him anywhere!"

Why does the medicine cost 2.1 million in the first place? Is it just price inflation or it's made of antimatter or something?

health insurance companies only profit when humans directly suffer.

we let this happen daily.

The American healthcare industry is the envy of the world.

Explain to me how this drug costs that much to manufacture

We need medicare for all so that this doesn't happen.

This is how we PROTECT BABIES!

How can one dose of medicine, literally any medicine, be 2 million dollars? JFC.

this is some martin shkrelli shit. Somebody needs to go to jail

Too bad, they are already born, otherwise this will be murder. -- Some Republican probably

Here’s their GoFundMe

Edit: see below, SomeoneElse is correct.

Something about this insurer stinks. How long does it take to drop a drug from their coverage, usually? And did they know the twins would need this drug before the mother knew? If that's the case, then her employer, who was also the insurance provider, had access to her healthcare records. They had access to all her information and likely paid her OB/GYN on the sly to tell them what was going on with the twins while in the womb.

NP just quit avocado toast

Novartis is another shit-stain-of-humanity drug company. Fuck Novartis.

May the insurance agency burn down with all employees inside 😊

This is literally the setup for the show Leverage

Something else needs cut, apparently.

Amurrrka! Land of the free!

We should simply pay for research with tax money and make drug patents illegal. It still would not fix this issue. We also need some form of public insurance.

In this case, the only option is bankruptcy.

Why is the drug so expensive? Does it have to do with patent laws, or is the actual manufacturing process ridiculously expensive?

Does it require rare materials?

"Based"?

Admirable; praiseworthy, especially if the thing that is considered "praiseworthy" is unpopular or controversial.

Sad truth: Nothing about this will change until the boomers are gone.

In a rational country the people responsible for making this decision would be forced to stand trial and be put to death.

Did they get it?

The cut coverage of the drug for everybody or just the mom? There's no reason for the drug to cost this much. They do this on purpose so less lives are saved.

“Based” isn’t the word I’d use.

The misfortunes of some are the business of others, that’s how capitalism works, I don’t know why some people are scandalized.