Our Springfield, Mo., community member, Mark Hall, is suffering from incredible pain because Cigna refused to pay for the medicine he needed. Mark has ulcerative colitis, a condition that causes internal bleeding, inflammation of the intestines, a feeling of constant pain, and degradation of the tissue in his mouth.
For a decade, the medicine Remicade kept his symptoms under control. But last year, Cigna refused to continue covering it and forced him onto a different medication, even after he’s paid his premiums for years. Cigna refused to do their job and cover the one treatment that kept Mark well. Instead, Cigna forced Mark to either pay $10,000 every two months for the care that works – or move to a cheaper drug that Mark’s doctors advised against
Like most Americans, Mark and his wife Callie could not afford that predatory price tag, so Mark stopped the treatment that worked and switched to a medicine that Cigna would cover. This new drug did not work for Mark. While Mark’s doctors appealed Cigna’s decision, Mark’s symptoms came back and caused Mark to go through immunogenicity, a process where Mark’s body now produces antibodies that attack the drug that relieved his suffering and others like it. So now the original medicine that had worked, won’t work now even if Cigna did cover it, and Mark must again try a different medication in the hopes of living a life without suffering.
Cigna prioritized their profits over the care Mark and patients like him need. That’s wrong.
Cigna can and must pay for medications prescribed by a medical professional. It’s their job. Cigna took in $5.4 billion in profit in 2021, so they can clearly afford this.
If a medical professional recommends a treatment, private insurance companies like Cigna must not force a patient to use another alternative if the switch could 1) cause the patient to reject the original medicine 2) replace an effective medicine with a medicine that may not work for them and may further their suffering.