[chiefalchemist]

> But if the standard treatments aren't working for you, do your own research and ask your doctor to try something else.

Sad. But true. That said, why don't the insurance companies know about successful alternatives? After paying out X, isn't it in their best interest - and the patients' best interest - to say, "Our data shows that these alternatives have been successful is similar cases. Perhaps there are somethings here to consider."

It's not a diagnosis, just data / possibilities. This might also encourage insurance companies to be less tight fisted about what they'll cover. That is, they're not blindly paying for fringe "experiment" but investing in solutions that will mitigate future payouts.

Smarter use of the data would means more choices and better care for patients, and more profits for insurance companies. Is that not a win win?

[mrblah]

In a way, the entire differential diagnosis process and treatment planning is already based on data. Your doctor and insurance companies don't think you're special. Autoimmune problems are so varied, everything from testing to biopsy to diagnosis to treatment is based on a slow moving and incomplete body of knowledge and doctors are generally conservative when it comes to straying from the pack. It's why published research is so important for doctors to keep up with. Luckily these antibiotics are cheap so insurance didn't even come into the equation for me.

[chiefalchemist]

Yes. But as treatment goes on and there is a lack of change / progress why wouldn't the insurance companies look for ways to save? They have the data. There are millions of patients and doctors, etc.

[mrblah]

1000% agree. I shudder to think what I would have done at the time if the non-standard treatment cost tens of thousands of dollars out of pocket because insurance wouldn't cover it. Through insurance coverages we're kinda locked into the meaty part of the curve when it comes to treatment options, unless you have money or your doctor really makes a good argument why something should be covered that goes against what insurance will cover for your condition.