August 5, 2015 — Anthem Blue Cross has been sued by a woman with hepatitis C who was denied the miracle drugs Harvoni and Sovaldi because she was not sick enough.
The woman, Marina Sheynburg, filed the class action lawsuit on July 24 in California federal court (Case No. 3:15-cv-03417).
She says Anthem denied “medically necessary treatment” in violation of the Employee Retirement Income Security Act (ERISA), according to Courthouse News.
The lawsuit states:
“In violation of ERISA statutes and regulations, Anthem has systematically ignored the treatment recommendations of insureds’ providers and used internal clinical guidelines which are inconsistent with the plain language of insureds’ plans.”
Harvoni and Sovaldi are once-daily pills made by Gilead Sciences that cure at least 94% of people with hepatitis C within three months. According to the lawsuit, the only alternative is a three-drug treatment that only cures 70% of patients and comes with a wide range of negative side effects.
Harvoni and Sovaldi have been hailed as “miracle drugs,” but with a price-tag of at least $84,000, almost no one can afford treatment in the United States. Unfortunately, many health insurers have restricted coverage for the drugs unless the patient has end-stage cirrhosis or fibrosis of the liver.
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