Deborah D. Gordon has spent her career trying to level the playing field for healthcare consumers. She is co-founder of, the premiere membership organization for independent advocates. She is the author of "The Health Care Consumer's Manifesto: How to Get the Most for Your Money," based on consumer research she conducted as a senior fellow in the Harvard Kennedy School's Mossavar-Rahmani Center for Business and Government.
Being switched off a treatment that is working for you can lead to medical complications, more HCP visits and more trial and error, plus disruptions to everyday life.To navigate health insurance coverage for heart medicines, it helps to understand some basics about how insurers decide which drugs to cover.PBMs negotiate drug prices with drug makers and set lists of drugs a health insurer will cover .
Prior authorization: You have to get the insurer’s permission before they will cover a drug. They review your request to decide if they believe you need the drug and if they think it’s the only or the best option for you. If they deny your request, you can appeal and try to get them to change their decision.
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The Importance of Black Cardiologists for Black PatientsBlack patients are more likely to receive preventative care when they see Black doctors, according to the National Institutes of Health.
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First-Ever CRISPR-Based Therapy Approved for Sickle Cell DiseaseU.S. patients with sickle cell disease now have a novel treatment option: the first-ever CRISPR-based therapy.for use in patients age 12 years and older. In addition to offering hope of relief for people with severe forms of the painful blood disorder, the treatment, called Casgevy, is the world’s first to genetically tweak cells using theAnother gene therapy for sickle cell disease, called Lyfgenia and developed by biotech company bluebird bio, based in Somerville, Mass., was also approved December 8. Getting a green light for the first CRISPR-based medicine is exciting, says David Altshuler, chief scientific officer at Boston-based Vertex Pharmaceuticals, which developed the drug in a joint venture with CRISPR Therapeutics, a company in Cambridge, Mass. But the fact that the drug fills an unmet need for underserved patients is “more compelling to me, personally, than the fact that it’s CRISPR.” , most of them Black or Latino, have sickle cell disease. It is caused by a genetic defect in hemoglobin, the oxygen-carrying protein in red blood cells
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