ATLANTA — A local mom says doctors at Children’s Healthcare of Atlanta prescribed her son a life-saving medication. But when she went to the pharmacy to fill the order she was told the medication was not covered by her insurance.
Nine-year-old Mattie McCoy spends a lot of time in the car these days. Several days a week his mother take them from their home in Coweta County to Atlanta.
“Mathew has Fibermitosis Type 1 and basically it is a genetic disorder where tumors can grow on nerve endings,” said his mother.
Tumors now cover Mattie’s body. He desperately needs chemotherapy to shrink his tumors. Doctors prescribed a medication called MeKinist.
“We had three leading experts saying that he needed this and yet the insurance company was saying we know more than your doctors,” she said. ” I was infuriated.”
Under FDA labeling, the medication is not approved for tumors. The pharmacy told her is she wanted the medicine she would have to pay out of pocket.
“At the highest dose, it is over $10,000 a month.”
Her team of doctors filed an appeal with CVS Caremark, which handles pharmaceutical benefits for the family’s insure United Healthcare. That appeal was denied but McCoy said she filed several more rounds of appeals when she almost felt like giving up.
“All I could think is I’ve got to try one more time. I hunted down the email addresses of every single CEO at CVS Caremark and I pled my son’s case.”
Mattie should have his first dose of chemotherapy medication by Thursday night.