Denial of Authorization Review

March 3, 2010

Dear [BRCA1 Bitch]:

We are writing in response to a request to cover Androderm.  We reviewed your [insurance] contract and information that your provider sent us.  Based on that information, we determined that the proposed service or treatment is not covered. This means that you will be responsible for payment if you decide to have the service or treatment.

This is not a covered benefit because it does not meet the criteria established by the [insurance] Pharmacy and Therapeutics Committee.  Your Plan will pay for this medication for male patients with low testosterone levels.  Androderm is not FDA approved for use in women.  According to the information submitted by your doctor, this criteria has not been met.

...

We understand that you may have questions about our decision.

....

Sincerely, [Older White Male, M.D.]

 

Actually, yes I do have a few questions.  These are probably best directed to the FDA, but here goes.

As a preface, I am extremely fortunate to have had insurance coverage for my entire breast cancer treatment and recovery.  I'd probably be dead or bankrupt/homeless without you.  I paid approximately $3,000 for treatment and surgeries that cost you more than half a million dollars.  You paid for them to take my boobs off, but to your credit, you also paid for them to put some boobs back on.  You covered the prophylactic hysterectomy as well as all of my chemotherapy, associated drugs, port, etc.

So I know this is really bitchy and self-centered, but what's another $175/month to help me get laid?  I'm 37 years old and I haven't had sex for well over a year.  My vagina has literally shriveled from lack of use.  I have zero libido - ZERO. Z-E-R-O.   I'm desperate to try anything.  There isn't anything on the market that the FDA has approved for women.  I have had extensive consultations with both my family practitioner and my oncologist, and they both feel that this is the best chance I have of ever having enjoyable sex again.  This is not going to get better on its own.

Please tell your brothers (and I say brothers with all the gender connotations that come with it) at the FDA that this situation is utterly and completely fucked up.  I have no ovaries.  I will never carry a fetus.  There is nothing to fuck up here.  I'm not asking to take estrogen (I know better - and it wouldn't affect my sex drive anyway).  I don't even have high hopes that testosterone patches will restore my sex drive.  At least the women in Canada and Europe have been allowed to give it a try.

If you have suggestions for alternatives to accepting that the rest of my life (whether I live another 5 years or another 50) will be completely devoid of sex, I'm all ears.  My vagina would love to know your suggestions.  I have a feeling that the only covered option you might offer is "sex therapy" with some shrink who can teach me to "love my body" again.  That's a beautiful thought, but that's going to require you to shell out at least $100/hour  -- and this testosterone patch is $175/month.  You do the math.    

Look, if I start growing a beard or have other signs of male puberty, I'll stop.  I have no interest in looking less sexy than I already do. 

I feel sorta guilty for bitching about this.  But I know if I was a dude and I couldn't get it up, you'd find a way to help me.

So, fuck you. 

 

Comments

[Rosa]

Right on. :)

[Rosa]

Hey, it ate the rest of my comment. :P  Just wanted to chime in with my support.  I'm a young(ish) survivor, and I totally echo and understand this comment.  I work for ChiliTechnology so thought I'd leave a tip for those currently in chemo -  my worst side effects from chemotherapy were heat, chills, sweats, and insomnia.  I started using a ChiliPad (it's a mattress pad that lets you cool or heat the bed to any temperature you set - it has a range from 46 to 118 degrees).  I also went on a macrobiotic diet, which really helped with detoxing from the chemo.  The other thing I did that was really important to my healing was watch tons of stand-up comedy. I really believe laughter is the best medicine.  Hang in there!