I expect the defendants to be a number of "insurance" companies, i.e. PPOs and/or HMOs.
The plaintiffs will be people like me who've had an experience like the following:
- My doctor prescribes a drug from the new class of zippity-doo-dah anti-diabetes / pro-weight-loss, etc. "miracle" drugs, e.g. Mounjaro, Ozempic, etc.;
- My pharmacy informs me that the insurer has rejected the prescription and requires that it be filled by another pharmacy;
- The other pharmacy informs me that they can't fill it until they receive a "prior authorization," which must be requested of the insurer by my doctor;
- My doctor requests the "prior authorization;"
- The "prior authorization" eventually arrives and I'm able to fill the prescription. One Time. Then;
- The pharmacy informs me that my doctor will need to get a new "prior authorization," or change the dosage, or something;
- Rinse and reuse some variation of the above sequence.
For the last 15 years or so, I've been on several prescription medications.
This is the only such medication I've had anything like this kind of situation with.
It's fairly obvious that the insurers (I'm sure mine isn't the only one, if for no other reason than that it is one branch of a company with subsidiaries all over the US) are trying to save money by slow-walking provision of the drugs, with a certain number of people just giving up on getting the drugs, dying while waiting for the drugs, etc.
I'm not the litigious type. In fact, I've never personally sued anyone, nor have I ever joined a "class action" suit as a plaintiff (I have received a few small settlements after those settlements have been reached, pursuant to being informed I'm eligible because I qualify as part of the "class").
What I'd like to see happen is for my "insurer" to just stop fucking around and letting my pharmacy provide the drugs I'm prescribed, with whatever reasonable applicable co-pay.
But at this point, when and if I do hear of litigation over this matter, I'll sign on as quick as I get handed a pen.
