Hi there,

I was told by my neurologist to get Ampyra, an old drug (4AP) re-worked
with a time-release formula to make it new, because it would help my walk..
4AP is made at compounding pharmacies, and I guess the strength of the drug
was hit or miss in the past.  4AP didn't get the same positive results in
testing that Ampyra received, probably for that reason.

The difference in price between the two drugs is quite noticable.. Ampyra
will cost Aetna over $1000 a month if not more.  4AP was about $25-30 a
month from what I understand.

My doc sent in the paperwork required. The insurance company rejected the claim.

What fun, and what else is new.. geez.

So I called Aetna to find out WHY???

The representative told me, it was simple.  I had to be on one of the CRAB
drugs (like copaxone, beta-seron, etc., etc.) in order to qualify for the
drug (their policy).

However... with the type of MS that I have, there is not a neurologist on
earth who will put me on those drugs, because they don't work with this
type of MS :) :)

I guess the insurace company wanted me to spend more of their money with
the CRAB drugs, and maybe make myself sicker as well .

SURE, we don't need a universal health care plan in the US ... Lol Though
I'd settle for getting rid of the insurance companies :)

My doc has appealed Aetna's decision, and from what I understand, his
letter to them was quite angry.

I'm sure the whole thing is going to boil down to delay, delay, delay.. and
their hope that if they reject the claim most patients won't go to the
trouble I did in calling them, and my Dr.'s office.

Take care,
Janis

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