Feature Archive

Getting the Care You Need

When insurance refuses coverage, drug companies may help out.

WebMD Feature

April 17, 2000 (San Francisco, Calif.) -- Five years ago, Suzanne F. was diagnosed with myelodysplastic syndrome, a potentially fatal blood disorder that she knew would require expensive and difficult treatment, possibly even a bone marrow transplant.

Then came this added insult: As if the diagnosis of this leukemia-like disease weren't enough, Suzanne now faced another problem: how to pay for Epogen, an extremely expensive biotech drug that her doctor said she needed to stimulate the production of red blood cells.

Unfortunately, Suzanne's health insurance wouldn't cover the drug, and she didn't have the resources to pay for it herself. Epogen costs about $8,000 per year for the average kidney dialysis patient. For her treatment, the amount she needed would cost six times that much.

What to do? At medical conferences concerning her disease, Suzanne learned that drug companies sometimes helped people in her situation. On her own, she went to Amgen, the Thousand Oaks, Calif., company that manufactures the drug, and to her great surprise and relief they agreed to supply it to her at no cost.

Using the drug stabilized Suzanne's condition so that she could continue working; it also bought her time to search for a bone marrow donor, says her attending physician Bradley Lewis, MD, director of hematology for the Alta Bates/Salick Comprehensive Cancer Center.