I’m mad. Really mad. But the MTHFR I’m referring to isn’t really a cuss word. But to be truthful – I am saying ugliness in my mind. Lots of it. Our healthcare system is so crazy broken it makes me nuts! And I’m a nurse. I’m so frustrated with how we treat addiction, mental illness and hand out some medication like it’s nothing but refuse to pay for life changing, root cause treating, important medical food and testing.
MTHFR refers to Methylenetetrahydrofolate Reductase and it just might change your life.
Seven months ago (one month after my mother had died)…something bad happened to someone I love…a serious medication reaction. Something that scared us and rattled me to the core. But that something bad led us to the most compassionate, empathetic, loving, knowledgeable physician we have ever met and we are thankful. She has been a bright light in a very dark world. She listened, believed, cared, taught and tested…when others had not. She performed lab tests… Pharmacogenetics, MTHFR and other blood work to help determine root causes when others had not. She truly saved us and I love her. Thankfully most everything was covered by our insurance company.
The Pharmacogenetics testing determined which medicine would be best metabolized and most therapeutic based on his DNA. The MTHFR revealed two genetic mutations which inhibited the ability to convert folic acid or even folate into a usable form. Deplin, a medical food was prescribed. Deplin is different from other medicines used to treat anxiety, panic attacks and depression. It’s non-addictive and it doesn’t just treat the symptoms. It gets to what many believe to be at least part of the root cause of so many illnesses….anxiety, depression, heart disease, fibromyalgia and so many others.
Deplin, MTHFR, pharmacogenetics and the sweet physician who brought these into our lives have been life changers in a really big and good way. The panic attacks have been controlled and the anxiety has greatly decreased (there is so much more but I’m trying to be discreet for him while sharing info that might help someone else). I stand on roof tops (someone exaggerating but not really) and shout out to anyone who passes by… “Go see Dr. (name omitted) and have the MTHFR and pharmacogenetics testing. She will change your life with her compassion, empathy and knowledge.” Several have listened. I seriously love her.
My mother who died from her addiction on April 1, 2015 suffered from years of anxiety…and addiction. I had never heard of MTHFR until a month after her death. I’m sure she was never tested for MTHFR or had pharmacogenetics testing. I would bet my life my mother had the MTHFR genetic mutations and just maybe if these had been identified years ago and she had been prescribed Deplin or something like it – maybe she would have stood a better chance of battling her addiction.
So why am I mad?
Because our healthcare as a whole is full of craziness!!!!
Yesterday, I found out as of 12/1/15 our insurance will no longer pay for Deplin!! So after seven months of panic attacks being controlled and anxiety being greatly decreased in a large part due to Deplin…a MEDICAL FOOD…our insurance will no longer pay for it because it’s considered a vitamin. However, the insurance will still pay for other medications that treat so many symptoms (not root cause) …and are addictive, full of chemicals, cause major drug/drug interactions, contribute to hospitalizations, rehabilitations and all kinds of ugliness. In all fairness…those medications I just referred to help people too. But being the child of an addict…I’ve seen a lot of ugly with medications (over seeking, over prescribing and abusing) and I’m furious that this medical food will no longer be covered by our insurance. The cheapest I know of is $60 for a month’s supply when paying cash. That $60 is nothing compared to adding other multiple medications to treat symptoms or paying for additional physician appointments, inpatient treatment or addiction treatment that insurance could incur as a result of not paying for Deplin or other medications that treat root causes instead of just symptoms. Don’t we want to treat the root cause instead of just treating symptoms? Don’t we want better outcomes? Don’t we want people to do well and succeed? I’m beginning to really wonder. I feel like a bunch of bozo’s are making really dumb decisions at our expense.
At the beginning of the year, I sat in on a presentation about pharmacogenetics testing. The lab was so excited because insurance companies including Medicare and the VA would be paying for the testing. This could potentially decrease many poor outcomes related to medications and save tons of money by preventing wrong medications (for their DNA) from being prescribed to a patient. During the presentation, I made a snide remark about how I bet Big Pharma wasn’t too happy about the testing. Because from my angle…it looked like they stood to lose a lot of profit if physicians were more accurate with their medication prescribing based on a person’s metabolism and DNA. I was assured Big Pharma backed the testing. I was shocked and grateful. But over the last several weeks…I’ve heard Medicare will no longer be paying for the pharmacogenetics testing. Really? I wonder why? While I used to believe positive outcomes were always the priority…I’m beginning to see…I’ve been quite ignorant.
So let me ask you…who benefits when a medicine like Deplin is no longer covered by insurance or when pharmacogenetics testing isn’t covered ensuring the right medication is prescribed more accurately…it sure isn’t the patient or the family. So who benefits? And what about those positive outcomes? What about saving money? What about fighting addiction? What about what’s best for the patient? The crazy thing is…all of those things are a hot topic within our Medicare programs, VA and government right now. Man we sure do dumb stuff.
We are in great hands. My loved one will get what is needed. I’ll file for and an exception with the insurance company and do whatever I need to do to ensure he gets what is needed. But I shouldn’t have to battle. What about the ones who can’t or don’t know better? This whole thing is just dumb.
Does anyone else see the craziness?
Check out these links to learn more:
Pharmacogenetics and medications
How a vitamin cured my anxiety
This is very frustrating. So disgusting that big companies can take away our rights because they aren’t making a profit on the bigger things helping patients. Seems selfish when our pharmaceutical companies are supposed to be researching and developing drugs that help heal/treat/cure patients. Hope you can make a small difference now, that results in big changes later!
Thankful he is with you getting the love & care he needs from family & an awesome physician
It’s so awful! The fact that the insurance company made the change as of 12/1/15 and we weren’t notified. We found out on 12/18/15 when the insurance company denied a payment to the pharmacy for the Deplin. So I called the insurance company and found out the reason – it was no longer a covered medication. Crazy! I’m so thankful for his physician!