Latest news with #IVIG
Hindustan Times
3 hours ago
- Health
- Hindustan Times
Cow milk turns nearly fatal for newborn baby
Pune: A 25-day-old baby from Pune had a close brush with death after being fed cow milk, a practice doctors strongly advise against. The newborn boy was admitted on on July 11 in critical condition to Kamla Nehru Hospital (KNH), where he was placed on ventilator support for the initial10 days. He was discharged on Thursday. Pune, India - June 11, 2018: A man taking milk from cow at Sukhsagar nagar katraj in Pune, India, on Monday, June 11, 2018. (Photo by Rahul Raut/HT PHOTO) The baby's mother, Nazia Shaikh (name changed), started giving cow milk to her newborn on the 10th day after birth. 'I thought he was crying because he wasn't getting enough from breastfeeding,' she said. Within days, the infant developed loose stools, became irritable, refused feeds, and cried inconsolably. He was brought to the Pune Municipal Corporation-run KNH on July 11, severely dehydrated and critically ill. Doctors diagnosed the baby with sepsis, metabolic acidosis, and necrotizing enterocolitis (NEC), a serious intestinal condition with a high mortality rate. The infant had dangerously low blood pressure and could not breathe on his own, said the doctors. Dr Smita Sangade, paediatrician at KNH, said, 'We had to intubate the baby and put him on a ventilator as he was going into respiratory failure. He was given medications to support his heart and blood pressure, along with powerful antibiotics and IV immunoglobulin (IVIG) to control the infection.' Due to complications from sepsis, the baby also required blood and platelet transfusions. He suffered severe fluid retention and protein loss, requiring special intravenous nutrition to sustain him. After 10 days of critical care, the baby's condition slowly improved. Doctors gradually removed him from oxygen support and restarted feeding. By day 36, he was tolerating full feeds. However, on day 39, the baby developed loose stools again. Doctors diagnosed secondary lactose intolerance caused by the earlier gut damage. His feeding formula was changed to a lactose-free alternative, and the mother was guided and supported to restart breastfeeding. Dr Sangade emphasised the risks of feeding cow milk to infants under six months. 'Cow milk can lead to dehydration, severe gut infections, electrolyte imbalance, and even sepsis. Newborns should only be given breast milk or medically approved infant formula. We strongly advise exclusive breastfeeding for the first six months,' she said.
Globe and Mail
16-06-2025
- Health
- Globe and Mail
Dermatomyositis Market Set to Advance with Improved Diagnosis and Emerging Immunotherapies by 2034
Dermatomyositis is a rare, chronic, inflammatory myopathy characterized by progressive muscle weakness and distinctive skin rashes, often associated with autoimmune mechanisms. It can occur in both adults and children and may involve complications such as interstitial lung disease, malignancy, and calcinosis. Despite its rarity, dermatomyositis remains a significant clinical concern due to its multisystem involvement, diagnostic complexity, and limited treatment options. DelveInsight's ' Dermatomyositis Market Insight, Epidemiology, and Market Forecast – 2034 ' provides an in-depth analysis of the current landscape and future outlook of the DM market across major geographies, including the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan. The report explores detailed epidemiological trends, segmentation by age and clinical subtypes, and diagnostic challenges that contribute to underreporting and delayed intervention. Current treatment regimens typically include corticosteroids, immunosuppressants (methotrexate, azathioprine), intravenous immunoglobulin (IVIG), and emerging biologics like rituximab. However, response rates vary, and long-term use can lead to significant side effects. A growing pipeline of investigational agents—targeting pathways such as type I interferons and B-cell modulation—offers promising avenues for disease-specific and steroid-sparing therapies. The Dermatomyositis market is projected to witness steady growth through 2034, fueled by increased disease recognition, clinical trial activity, and strategic advancements by pharmaceutical companies. Biotech firms and academic institutions are exploring novel immunomodulatory agents and precision medicine approaches to improve outcomes in both adult and pediatric populations. DelveInsight's report is an essential resource for pharmaceutical executives, clinical researchers, investors, and healthcare professionals who seek strategic insights into the evolving DM landscape, from market dynamics and unmet needs to the competitive pipeline shaping the future of dermatomyositis care. Some of the Key Facts of the Dermatomyositis Market Report: • In 2023, the dermatomyositis market in the 7MM was valued at approximately USD 187 million, and is projected to grow at a CAGR of 16.8% due to improved disease awareness, diagnostics, and the introduction of new therapies. • The U.S. had the highest number of diagnosed cases, with around 38.5K in 2023. • Across the 7MM, there were nearly 72K diagnosed prevalent cases in 2023, with 91% in adults and 9% in juveniles. • The U.S. accounted for ~54% of total diagnosed cases, while EU4 and the UK represented about 29%, and Japan ~17%. • In January 2025, RESTEM announced that the FDA granted Fast Track designation for its Restem-L program, using umbilical cord outer lining stem cells (ULSCs) to treat Polymyositis and Dermatomyositis (PM/DM), now classified as Idiopathic Inflammatory Myopathy (IIM). This follows the recent Orphan Drug Designation for Restem-L in IIM. • In July 2024, Priovant Therapeutics announced the completion of enrollment for its Phase 3 VALOR trial evaluating brepocitinib in dermatomyositis. With 241 participants across 90 sites on four continents, it is the largest interventional trial ever conducted for the condition. • Leading companies in the Dermatomyositis market include Kezar Life Sciences, Argenx, Pfizer, CSL Behring, Viela Bio, PAEAN Biotechnology, Alexion Pharmaceuticals, and others. • Emerging acute Dermatomyositis drugs include KZR-616, EFG PH20, PF 06823859, Hizentra, Daxdilimab, PN 101, Ravulizumab, and others. • The increasing prevalence of dermatomyositis and ongoing advancements in therapeutic options are driving the demand for more effective treatment approaches. To know in detail about the dermatomyositis market outlook, drug uptake, treatment scenario, and epidemiology trends, click here: Dermatomyositis Market Forecast Dermatomyositis Overview Dermatomyositis is a rare, systemic autoimmune disorder characterized by chronic inflammation of the skin and muscles. It presents with hallmark features such as symmetric proximal muscle weakness and distinctive skin rashes, including the heliotrope rash and Gottron's papules. The condition may also affect other organs, including the lungs, esophagus, and heart, and is sometimes associated with malignancy, especially in adults. Dermatomyositis affects both adults and children (juvenile dermatomyositis), with varying severity. Its exact etiology remains unclear but is believed to involve a combination of genetic predisposition, immune system dysregulation, and environmental triggers. Diagnosis typically involves a combination of clinical findings, elevated muscle enzymes, electromyography (EMG), imaging studies, skin/muscle biopsies, and autoantibody testing. Management of dermatomyositis requires a multidisciplinary approach, involving dermatologists, rheumatologists, neurologists, and physical therapists. While there is no cure, a range of therapies aim to control inflammation, alleviate symptoms, and prevent complications. Get a free sample of the dermatomyositis market report with key insights and emerging therapies here: Dermatomyositis Epidemiology The epidemiology section provides insights into the historical, current, and forecasted epidemiology trends in the seven major countries (7MM) from 2020 to 2034. It helps to recognize the causes of current and forecasted trends by exploring numerous studies and views of key opinion leaders. The epidemiology section also provides a detailed analysis of the diagnosed patient pool and future trends. Dermatomyositis Epidemiology Segmentation: The Dermatomyositis epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by: • Diagnosed Dermatomyositis prevalence • Type-specific Diagnosed Dermatomyositis prevalence • Age-specific Diagnosed Dermatomyositis prevalence • Gender-specific Diagnosed Prevalent Cases of Dermatomyositis • Severity-specific Diagnosed Prevalent Cases of Dermatomyositis • Chronicity-specific Diagnosed Prevalent Cases of Dermatomyositis Download the report to understand which factors are driving dermatomyositis epidemiology trends @ Dermatomyositis Epidemiology Forecast Dermatomyositis Drugs Uptake and Pipeline Development Activities The Dermatomyositis drugs uptake section examines the rate at which newly launched or upcoming potential drugs are being adopted in the Dermatomyositis market during the study period. This analysis covers drug uptake, patient adoption of therapies, and the sales performance of each drug. Additionally, the therapeutics assessment section highlights the drugs with the most rapid uptake, shedding light on the factors driving their widespread use. It also provides a comparative analysis of these drugs based on their market share. The report further delves into the Dermatomyositis pipeline development activities, offering key insights into various therapeutic candidates in different stages of development and the major companies behind these innovations. It also covers recent collaborations, acquisitions, mergers, licensing agreements, patent details, and other critical information related to emerging therapies. Dermatomyositis Market Outlook While there is no definitive cure for dermatomyositis, available treatments aim to reduce inflammation, control symptoms, and improve quality of life. The approval of OCTAGAM and the development of multiple clinical management guidelines—such as those from the British Society for Rheumatology and the Japanese Society of Rheumatology—have significantly shaped and standardized the therapeutic landscape. Treatment often begins with corticosteroids to manage muscle inflammation, followed by immunosuppressants or immunomodulators like methotrexate, azathioprine, or mycophenolate mofetil to reduce steroid dependency. For resistant or severe cases, advanced therapies such as rituximab, IVIG, and calcineurin inhibitors are employed. In terms of skin manifestations, management includes both topical agents (e.g., corticosteroids, calcineurin inhibitors) and systemic medications like hydroxychloroquine. Adjunctive strategies such as physiotherapy, sun protection, and dietary interventions are also integral. A growing pipeline featuring therapies like Brepocitinib (Priovant/Pfizer), Dazukibart (Pfizer), Efgartigimod (Argenx), and SAPHNELO (AstraZeneca) reflects an evolving research focus on immunomodulation and interferon signaling pathways. These emerging agents, combined with better diagnostics and increasing disease awareness, are expected to drive market growth through 2034. Dermatomyositis Market Strengths • A strong research focus on immune pathways (e.g., JAK-STAT, interferon) has led to promising investigational drugs such as Brepocitinib and Anifrolumab, indicating future therapeutic breakthroughs. • Increasing awareness among clinicians and availability of diagnostic tools (e.g., autoantibody profiling, MRI) enable earlier diagnosis and more tailored treatment strategies. Dermatomyositis Market Weaknesses • Despite multiple treatment options, none offer a cure, and many patients experience relapses or partial responses, necessitating lifelong management. • A significant portion of treatment regimens relies on off-label drug use, which lacks robust clinical trial data, leading to variable efficacy and safety outcomes across patient populations. Scope of the Dermatomyositis Market Report • Study Period: 2020–2034 • Coverage: 7MM [The United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan] • Key Dermatomyositis Companies: Kezar Life Sciences, Argenx, Pfizer, CSL Behring, Viela Bio, PAEAN Biotechnology, Alexion Pharmaceuticals, and others. • Key Dermatomyositis Therapies: KZR-616, EFG PH20, PF 06823859, Hizentra, Daxdilimab, PN 101, Ravulizumab, and others. • Dermatomyositis Therapeutic Assessment: Dermatomyositis, currently marketed, and Dermatomyositis emerging therapies • Dermatomyositis Market Dynamics: Dermatomyositis market drivers and Dermatomyositis market barriers • Competitive Intelligence Analysis: SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies • Dermatomyositis Unmet Needs, KOL's views, Analyst's views, Dermatomyositis Market Access and Reimbursement To learn more about the key players and advancements in the dermatomyositis treatment landscape, visit the Dermatomyositis Market Analysis Report Table of Contents 1. Dermatomyositis Market Report Introduction 2. Executive Summary for Dermatomyositis 3. SWOT analysis of Dermatomyositis 4. Dermatomyositis Patient Share (%) Overview at a Glance 5. Dermatomyositis Market Overview at a Glance 6. Dermatomyositis Disease Background and Overview 7. Dermatomyositis Epidemiology and Patient Population 8. Country-Specific Patient Population of Dermatomyositis 9. Dermatomyositis Current Treatment and Medical Practices 10. Dermatomyositis Unmet Needs 11. Dermatomyositis Emerging Therapies 12. Dermatomyositis Market Outlook 13. Country-Wise Dermatomyositis Market Analysis (2020–2034) 14. Dermatomyositis Market Access and Reimbursement of Therapies 15. Dermatomyositis Market Drivers 16. Dermatomyositis Market Barriers 17. Dermatomyositis Appendix 18. Dermatomyositis Report Methodology 19. DelveInsight Capabilities 20. Disclaimer 21. About DelveInsight About DelveInsight DelveInsight is a leading Healthcare Business Consultant and Market Research firm focused exclusively on life sciences. It supports Pharma companies by providing comprehensive end-to-end solutions to improve their performance. It also offers Healthcare Consulting Services, which benefit from market analysis to accelerate business growth and overcome challenges with a practical approach. Media Contact Company Name: DelveInsight Contact Person: Jatin Vimal Email: Send Email Phone: +14699457679 Address: 304 S. Jones Blvd #2432 City: Las Vegas State: Nevada Country: United States Website:
Yahoo
10-06-2025
- Business
- Yahoo
Claimable Honored in Fast Company's 2025 World Changing Ideas Awards
Annual Awards Recognize Innovative Companies and Projects Addressing the World's Most Urgent Challenges Recognition Follows Claimable's Launch of GLP-1 Support, Helping Patients Navigate One of the Most Denied Treatments in the U.S. SACRAMENTO, Calif., June 10, 2025 (GLOBE NEWSWIRE) -- Claimable is proud to announce that it has been named to Fast Company's 2025 World Changing Ideas Awards list. This annual recognition honors bold and transformative efforts that tackle the world's most pressing issues—from fresh sustainability initiatives and cutting-edge AI developments to ambitious pursuits of social equity helping mold the world. Every year, 850 million healthcare claims are denied, forcing millions of Americans to choose between medical care and financial stability. Claimable is tackling this healthcare crisis with the first AI-powered appeals platform, helping patients and providers fight back against unjust denials. Patients upload their denial notice and insurance information, answer a few questions, and Claimable does the rest, analyzing clinical research, policy details, appeals data, and their unique medical story to generate and submit a customized appeal in minutes. This year's awards showcase 100 outstanding projects. A panel of Fast Company editors and reporters selected the winners from a pool of more than 1,500 entries and judged applications based on their impact, sustainability, design, creativity, scalability, and ability to improve society. 'The World Changing Ideas Awards have always been about showcasing the art of the possible,' says Fast Company editor-in-chief Brendan Vaughan. 'We're proud to recognize the organizations and leaders that are making meaningful progress on the biggest issues of our time.' Since launching in late 2024, Claimable has recovered nearly $6 million for patients, boasting an over 80% success rate across more than 70 commonly denied treatments, including autoimmune and migraine medications, IVIG for children with PANS/PANDAS, and now GLP-1s for obesity and type 2 diabetes. For the millions facing treatment delays or crushing medical debt, Claimable offers hope, making the appeals process simple, fast, and effective, getting patients the care they deserve. 'We're using AI to solve a deeply human problem,' said Claimable Co-Founder and Chief AI Officer Zach Veigulis. 'Fast Company's recognition reinforces what we've always believed at Claimable, that AI can be used to make life better. At a time when technology is often used to cut costs and deny care, we're proving it can expand access and return power to patients.' This recognition comes as Claimable expands its impact with support for GLP-1 medication appeals. One of today's most denied treatment categories, GLP-1s like Ozempic, Mounjaro, Zepbound, and Wegovy have transformed care for people with obesity and type 2 diabetes. However, patients are often denied access due to formulary exclusions, overly restrictive eligibility criteria, or insurer mandates to 'fail first' on older or less effective treatments. With over 137 million U.S. adults now eligible for GLP-1 support, Claimable offers patients and providers a purpose-built solution designed to overcome the unique challenges of GLP-1 coverage denials. "Insurance denials aren't just a paperwork issue, they're a public health crisis hiding in plain sight," said Alicia Graham, co-founder and COO at Claimable. "While others patch old systems, we're building something entirely new. We're reimagining how healthcare access should work, using technology to turn the tables on a system that's stacked against patients. That's why we've built Claimable alongside the people most affected: patients and providers. Our platform works because it doesn't just make appeals faster, it makes them smarter, giving people the best chance to win." Claimable is available nationwide and accepts denials from all insurance providers, including Medicare, Medicaid, United Healthcare, Anthem, Aetna, Cigna, and BCBS plans. To learn more about Claimable and all the treatments they support, visit ABOUT CLAIMABLEClaimable revolutionizes the way patients and providers fight healthcare denials, helping ensure everyone has access to the care they need and the coverage they deserve. The platform leverages purpose-built AI to analyze clinical research, policy details, appeals data, and patients' unique medical stories, generating and submitting customized appeals in minutes. Claimable is available nationwide, accepting denials from all insurance providers, including Medicare and Medicaid. A NVIDIA Inception Program member, Claimable continues to push the boundaries of AI innovation in healthcare. For more information: Contact:Emily Foxpress@ in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Time of India
02-06-2025
- Health
- Time of India
Sree Chitra completes six new tech transfers
Thiruvananthapuram: The Sree Chitra Tirunal Institute for Medical Sciences (SCTIMST), which has a long history of technology transfers and commercialisation of medical devices and biomaterials, made six new technological transfers, including a deep brain stimulator. The indigenous development of a deep brain stimulator is for managing movement disorders such as Parkinson's disease and dystonia. The project was initiated with support from the technical research centre of the department of science and technology, Govt of India. Another technology transfer made is the "mice transfer and enrichment box-tunnel system with securing gates." Laboratory mice constitute over 87% of the total laboratory animals used in research. The test results using this system show that it can not only reduce stress during handling and cage shifting of animals but also act as an enrichment material inside the cage to reduce fighting behaviour and other unwanted behaviour observed in laboratory mice. The "plasma proteins fibrinogen, thrombin albumin and IVIG" technology is a small-scale fractionation of plasma to obtain four plasma proteins: Fibrinogen, Thrombin, Albumin, and Immunoglobulin. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like 5 Books Warren Buffett Wants You to Read In 2025 Blinkist: Warren Buffett's Reading List Undo Fibrinogen concentrate and thrombin are two major proteins of blood plasma. It has enormous potential in the preparation of wound healing matrices, tissue adhesives, and haemostats. Albumin is used as a replacement therapy in cases where blood volume loss occurs, liver diseases, and cancer. Two main uses for IVIG are as replacement therapy in primary or acquired antibody deficiency disorders and as immunomodulatory agents in patients with autoimmune or inflammatory conditions, and it has enormous potential. The "intracranial and subdural electrodes" technology are critical tools in neurology essential for electrocorticography and targeted cortical stimulation. But globally sourced electrodes are prohibitively expensive, limiting access in many parts of the world. To address this need, an indigenous development initiative was launched. The "chitosan-based antioxidant polymeric wound dressings for controlled antibiotic delivery" is an advanced wound care material intended for treating chronic and infected wounds. The last technology transfer made was on the reference materials for biological evaluations. For meeting the regulatory requirements in biocompatibility evaluations, as per international standards ISO 10993, a proof of concept project under TRC was completed at calibration cell, SCTIMST, for the development and standardisation of in-house reference biomaterials.
Yahoo
25-05-2025
- Health
- Yahoo
‘They won't help me': Sickest patient face insurance denials despite policy fixes
In 2023, Sheldon Ekirch was diagnosed with small fiber neuropathy, which makes her limbs and muscles feel as if they're on fire. Specialists recommended a series of infusions to ease her pain, but her insurer refused to pay for the expensive treatment, which it says is 'not considered medically necessary.' (Ryan M. Kelly for KFF Health News) HENRICO, Virginia — Sheldon Ekirch spends a lot of time on hold with her health insurance company. Sometimes, as the minutes tick by and her frustration mounts, Ekirch, 30, opens a meditation app on her phone. It was recommended by her psychologist to help with the depression associated with a stressful and painful medical disorder. In 2023, Ekirch was diagnosed with small fiber neuropathy, a condition that makes her limbs and muscles feel as if they're on fire. Now she takes more than a dozen prescriptions to manage chronic pain and other symptoms, including insomnia. 'I don't feel like I am the person I was a year-and-a-half ago,' said Ekirch, who was on the cusp of launching her law career, before getting sick. 'Like, my body isn't my own.' Ekirch said specialists have suggested that a series of infusions made from blood plasma called intravenous immunoglobulin — IVIG, for short — could ease, or potentially eradicate, her near-constant pain. But Ekirch's insurance company has repeatedly denied coverage for the treatment, according to documents provided by the patient. Patients with Ekirch's condition don't always respond to IVIG, but she said she deserves to try it, even though it could cost more than $100,000. 'I'm paying a lot of money for health insurance,' said Ekirch, who pays more than $600 a month in premiums. 'I don't understand why they won't help me, why my life means so little to them.' For patient advocates and health economists, cases like Ekirch's illustrate why prior authorization has become such a chronic pain point for patients and doctors. For 50 years, insurers have employed prior authorization, they say, to reduce wasteful health care spending, prevent unnecessary treatment, and guard against potential harm. The practice differs by insurance company and plan, but the rules often require patients or their doctors to request permission from the patient's health insurance company before proceeding with a drug, treatment, or medical procedure. The insurance industry provides little information about how often prior authorization is used. Transparency requirements established by the federal government to shed light on the use of prior authorization by private insurers haven't been broadly enforced, said Justin Lo, a senior researcher for the Program on Patient and Consumer Protections at KFF, a health information nonprofit that includes KFF Health News. Yet it's widely acknowledged that prior authorization tends to disproportionately impact some of the sickest people who need the most expensive care. And despite bipartisan support to reform the system, as well as recent attempts by health insurance companies to ease the burden for patients and doctors, some tactics have met skepticism. Some insurers' efforts to improve prior authorization practices aren't as helpful as they would seem, said Judson Ivy, CEO of Ensemble Health Partners, a revenue cycle management company. 'When you really dive deep,' he said, these improvements don't seem to touch the services and procedures, such as CT scans, that get caught up in prior authorization so frequently. 'When we started looking into it,' he said, 'it was almost a PR stunt.' When Arman Shahriar's father was diagnosed with follicular lymphoma in 2023, his father's oncologist ordered a whole-body PET scan to determine the cancer's stage. The scan was denied by a company called EviCore by Evernorth, a Cigna subsidiary that makes prior authorization decisions. Shahriar, an internal medicine resident, said he spent hours on the phone with his father's insurer, arguing that the latest medical guidelines supported the scan. The imaging request was eventually approved. But his father's scan was delayed several weeks — and multiple appointments were scheduled, then canceled during the time-consuming process — while the family feared the cancer would continue to spread. EviCore by Evernorth spokesperson Madeline Ziomek wrote in an emailed statement that incomplete clinical information provided by physicians is a leading cause of such denials. The company is 'actively developing new ways to make the submission process simpler and faster for physicians,' Ziomek said. In the meantime, Shahriar, who often struggles to navigate prior authorization for his patients, accused the confusing system of 'artificially creating problems in people's lives' at the wrong time. 'If families with physicians are struggling through this, how do other people navigate it? And the short answer is, they can't,' said Shahriar, who wrote about his father's case in an essay published last year by JAMA Oncology. 'We're kind of reaching a tipping point where we're realizing, collectively, something needs to be done.' The fatal shooting of UnitedHealthcare CEO Brian Thompson on a New York City sidewalk in December prompted an outpouring of grief among those who knew him, but it also became a platform for public outrage about the methods insurance companies use to deny treatment. An Emerson College poll conducted in mid-December found 41% of 18- to 29-year-olds thought the actions of Thompson's killer were at least somewhat acceptable. In a NORC survey from the University of Chicago conducted in December, two-thirds of respondents indicated that insurance company profits, and their denials for health care coverage, contributed 'a great deal/moderate amount' to the killing. Instagram accounts established in support of Luigi Mangione, the 26-year-old Maryland suspect accused of murder and terrorism, have attracted thousands of followers. 'The past several weeks have further challenged us to even more intensely listen to the public narrative about our industry,' Cigna Group CEO David Cordani said during an earnings call on Jan. 30. Cigna is focused on 'making prior authorizations faster and simpler,' he added. The first Trump administration and the Biden administration put forth policies designed to improve prior authorization for some patients by mandating that insurers set up electronic systems and shortening the time companies may take to issue decisions, among other fixes. Hundreds of House Democrats and Republicans signed on to co-sponsor a bill last year that would establish new prior authorization rules for Medicare Advantage plans. In January, Republican congressman Jefferson Van Drew of New Jersey introduced a federal bill to abolish the use of prior authorization altogether. Meanwhile, many states have passed legislation to regulate the use of prior authorization. Some laws require insurers to publish data about prior authorization denials with the intention of making a confusing system more transparent. Reform bills are under consideration by state legislatures in Hawaii and elsewhere. A bill in Virginia approved by the governor March 18 takes effect July 1. Other states, including Texas, have established 'gold card' programs that ease prior authorization requirements for some physicians by allowing doctors with a track record of approvals to bypass the rules. No one from AHIP, an insurance industry lobbying group formerly known as America's Health Insurance Plans, was available to be interviewed on the record about proposed prior authorization legislation for this article. But changes wouldn't guarantee that the most vulnerable patients would be spared from future insurance denials or the complex appeals process set up by insurers. Some doctors and advocates for patients are skeptical that prior authorization can be fixed as long as insurers are accountable to shareholders. Kindyl Boyer, director of advocacy for the nonprofit Infusion Access Foundation, remains hopeful the system can be improved but likened some efforts to playing 'Whac-A-Mole.' Ultimately, insurance companies are 'going to find a different way to make more money,' she said. During the summer of 2023, Ekirch was working full time and preparing to take the bar exam when she noticed numbness and tingling in her arms and legs. Eventually, she started experiencing a burning sensation throughout her body. That fall, a Richmond-area neurologist said her symptoms were consistent with small fiber neuropathy, and, in early 2024, a rheumatologist recommended IVIG to ease her pain. Since then, other specialists, including neurologists at the University of Virginia and Virginia Commonwealth University, have said she may benefit from the same treatment. There's no guarantee it will work. A randomized controlled trial published in 2021 found pain levels in patients who received IVIG weren't significantly different from the placebo group, while an older study found patients responded 'remarkably well.' 'It's hard because I look at my peers from law school and high school — they're having families, excelling in their career, living their life. And most days I am just struggling, just to get out of bed,' said Ekirch, frustrated that Anthem continues to deny her claim. In a prepared statement, Kersha Cartwright, a spokesperson for Anthem's parent company, Elevance Health, said Ekirch's request for IVIG treatment was denied 'because it did not meet the established medical criteria for effectiveness in treating small fiber neuropathy.' On Feb. 17, her treatment was denied by Anthem for the final time. Ekirch said her patient advocate, a nurse who works for Anthem, suggested she reach out to the drug manufacturer about patient charity programs. 'This is absolutely crazy,' Ekirch said. 'This is someone from Anthem telling me to plead with a pharmacy company to give me this drug when Anthem should be covering it.' Her only hope now lies with the Virginia State Corporation Commission Bureau of Insurance, a state agency that resolves prior authorization disputes between patients and health insurance companies. She found out through a Facebook group for patients with small fiber neuropathy that the Bureau of Insurance has overturned an IVIG denial before. In late March, Ekirch was anxiously waiting to hear the agency's decision about her case. 'I don't want to get my hopes up too much, though,' she said. 'I feel like this entire process, I've been let down by it.' KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
