14 year old, Cystic fibrosis patient is suing Medicaid for the right to get the expensive drug Kalydeco by Vertex paid. Medicaid is denying this Arkansas plaintiff the drug as they believe older drugs have not been exhausted yet in this patient. Over the years, patient’s lung function has decrease from 90% to 70% and according to her doctor, could have been prevented if she was not denied Kalydeco. Vertex’s assistance program has also denied helping since patient is under Medicaid coverage. What are your thoughts about this case and in general about cost containment of expensive medications?
For additional information, please see The Wall Street Journal.