Richmond woman seeking needed medication pushes lawmakers for insurance changes

RICHMOND, Va. (WRIC) — A Richmond woman with a crippling disease is pleading with lawmakers to make it easier for patients across the state to get the medications they need.

“It’s a nightmare and it’s worse every year,” Denise Marksberry said.

Marksberry says she’s been living with rheumatoid arthritis since she was four. She’s always been able to get the necessary medication, until a few years ago when her insurance company started requiring “step therapy,” which forces patients to go through different steps of different medications. Only if those medications fail can a patient move on to the medication prescribed by their doctor.

“I don’t want to go through this,” Marksberry sid. “I don’t want anybody to go through this. It’s not fair and it’s not right.”

“I don’t want to go through this. I don’t want anybody to go through this. It’s not fair and it’s not right.” — Denise Marksberry

Marksberry addressed lawmakers Tuesday in hopes they’ll make it easier for doctors to get exceptions if they don’t think the mandated drugs are in their patient’s best interest.

349879b1fd694167972231d4ec4ca6e3“It’s not about the cost for us patients, it’s about the medication that we need,” Marksberry added.

‘We are committed to making sure that our patients are not harmed,” said Dr. Olabisi Oshikanalu, medical director for Aetna.

Oshikanlu says the insurance companies use independent objective evidence to determine what prescriptions are in step therapy.

“It’s not something that health plans pull out of a hat, we actually look at this evidence,” Oshikanalu said.

She says the goal is making sure medications are safe, they work, and are cost effective. Oshikanalu says medications pushed by pharmaceutical companies or doctors aren’t always the best choice.

“They might be the most expensive, they might be the newest but they have not really stood the test of time,” said Oshikanalu.

Regardless Marksberry says she’ll push for change.

“I’m hopeful, very hopeful and I will continue to fight until we get some help and it is changed.”

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