Again…..I no longer know what to say: a plea for mercy from the state of Tennessee

I am at the point that I no longer know what to say. Less than a month ago Linda had a fight with TennCare to continue her ant-seizure medication lamictal. For her it was literally a life saving battle. We talked about this in an earlier post ( History has repeated.

This time it is not lamictal but cymbalta. Cymbalta is primarily an antidepressant medication, but is also prescribed for certain kind of pain. It is as a pain medication that Linda takes this drug.

The facts of the situation are fairly clear.

1. Linda is down to two or three days of cymbalta.
2. She has been taking it for several months now with no problem from TennCare. Her prescription says she has 3 refills left.
3. Her pharmacy tells her that Tenn Care is now saying they will not fill this medication without a prior authorization. Several months after starting it they are now saying they need a prior authorization.
4. Linda has left the care of the doctor who prescribed the medication. There is no one to pre-authorize.
5. None of her other doctors are willing to pre-authorize a drug they did not prescribe.

We are stuck between the rock and no place. We have no idea or clue about why after all these months TennCare is demanding a pre-authorization. None whatsoever. We have received nothing from TennCare explaining this decision or giving us any notice of appeal. Nothing.

The problem in this, the extraordinary emergency of this decision is in what it means to withdraw suddenly without warning or medical supervision from cymbalta.

Common symptoms of cymbalta withdrawal.  These symptoms can start with one missed dose.  They can last for months.  The most common description given by people who go through it is “living nightmare.”  There are multiple incidents of documented suicides.

Brain zaps – electric shock-like sensations in head
Body zaps – electronic shock-like sensations in body (not in head)
Extreme mood swings
Agitation and/or irritability
AggressionNightmares and/or sleep disturbance
Dizziness and/or light-headedness
Headache and/or migraines
Nausea and/or vomiting
Excessive sweating
Memory and concentration difficulties
Suicidal thoughts (ideation)
Suicide attempts
Hallucination and/or sensory disturbances
Flu-like symptoms (abdominal discomfort, weakness, etc.)

Linda is days away from hell, a hell brought on by an arbitrary decision from an insurance company. With all the other medical issues she already deals with this is an extraordinary act of cruelty. Perhaps a few dollars may be saved but the crisis they seem intent on throwing Linda into will cost far more than any savings on medication. It is cruel, without reason or rhyme, and in the long run more expensive both on a financial and human level. It is morally wrong, medically dangerous and simply stupid.

Our position is simple. You have been filling the medication. Continue to fill it. Nothing has changed that justifies them doing this to Linda. She has 3 more refills. Give her a chance to talk with new doctors and see how they feel about the cymbalta. That seems to be only reasonable.

Act now. Time is of the essence. Please do no injury to my wife. Please.

We will talk to Tenn Care in the morning we hope. We would appreciate any support you can give. Email Governor Haslam and ask for his assistance. Share this post widely.

I don’t know anymore what to say. Pray that the state will make a wise decision. Ask them to be merciful and not hurt my wife.

And pray for each of us to stay steadfast and determined. Right now….. well right now….Please keep us in your prayers.

Thank you

Larry Drain

3 thoughts on “Again…..I no longer know what to say: a plea for mercy from the state of Tennessee”

  1. Larry, the things they are doing to you has to do with their formulary which they change, usually at the beginning of the year but who knows when Tenn Care changes it.

    This happened to me last year for a drug I had been on for over a decade-Lexapro which has a generic. That made it even harder to understand since the generics aren’t that expensive.

    Well, I didn’t realize I had to get prior auth last year when my managed care pharmacy company was changed by my husband’s plan. I freaked out too because I have had withdrawal problems from just missing a couple of doses of this drug.

    I did get prior auth and though everything would be fine though but then they cut my off again this year without notice and only gave me enough for 2 weeks. I freaked out again but found some extra to help me through. I then, discovered that I had to apply for prior auth. every year.

    From what you have described Cymbalta would be a commonly prescribed drug for that purpose. Is it possible to see a doc who specializes in that to do the pre auth?

    The other thing that might have to happen is for you to go to the ER and tell them that she is starting to have withdrawal symptoms because she is only taking half of the dosage to make the pills last longer which is what I actually had to do for a few days before my preauth came through. None of this is fun. 😦

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