WEST HOLLYWOOD (CBSLA.com) — A West Hollywood woman is fighting her insurance company after she says it refused to cover the cost of an expensive drug she says would cure her of hepatitis C.
Newlyweds Shima Andre and her husband tell CBS2’s Peter Daut that their plans to have a baby were abruptly postponed after they found out Shima was infected with the liver virus.
“It’s possible to pass the virus down to your child,” said 42-year-old Andre, who explained that it’s unclear how or when she was infected. “I’ve been living in a constant state of distress for a long time now.”
Andre said she was thrilled when the U.S. Food and Drug Administration recently approved Harvoni, a daily pill shown to cure hepatitis C in more than 90 percent of patients.
But the drug is expensive and costs nearly $100,000.
Andre’s insurance company, Anthem Blue Cross, sent her a letter refusing to pay for the drug since her liver is not scarred enough.
“When they are saying, ‘You have to reach that window where you’re really sick. You’re not dead quite yet. Let’s try to guess … Let’s ride this out and see when we …’ You know, it doesn’t make any sense,” said Ted Andre, her husband.
Anthem Blue Cross says it can’t comment on pending litigation.
Ricardo Echeverria, the couple’s attorney, says he wants all insurers to work with pharmaceutical companies to find a price that does not leave patients hanging in the balance.
“What our goal is is to change the medical policy of the health and insurance industry to pay for this treatment. It’s a cure,” Echeverria said.
Andre says she hopes to get the drug soon so she and her husband can finally start a family.
“Of course, I want to get cured and move on with my life,” she said.
Echeverria says he’s already been contacted by nearly a dozen other people infected with hepatitis c whose insurance companies also refused to pay for the drug.