this post was submitted on 05 Jun 2025
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American health insurance companies are famously miserly, and this seems like a great area to use penny pinching for good. Where the hell are the insurance CFOs who should be demanding efficacy proof instead of being swindled along with the masses?
They’re busy researching new and exciting ways of denying coverage.
They absolutely do this. A drug with a lack of efficacy data is a great way to get shortlisted to insurance denials
It’s one of the frustrating things bc people can then easily manipulate the issue. A drug that can be prescribed a doctor and filled by a pharmacy being denied by an insurance company is very easy to write about online. Then it’s a slam piece, “x insurance company denied me my meds”. Basically 0 people will have any interest in the nuance that the medication is bullshit or possibly even harmful. Too bad insurance companies made their bed by being absolutely horrible for decades, I guess.
From the article:
I’m guessing their citation only includes Medicare and Medicaid because those have publicly-available data for the study to review, but I have to assume that private insurers pay a ton as well. I can see your point that insurance denials result in angry sick people, but there’s not really a lot of nuance in “that medication has never been shown to be safe and effective for your (or any) condition.”
I dunno. Everyone sucks here.