@lvnl Here is a different viewpoint to consider.

Insurers and Medicare need to control costs when and where possible to avoid more premium increases. I know many people insurance companies believe are rich and can afford everything, but when I think about what my medical care and prescriptions cost, the $10,000 I pay in premiums and the $10,000 or so my employer contributes don't begin to cover the costs of my husband's & my care, even with the discounts the pharmacy benefit managers negotiate, and the limits Medicare places on charges.

Whenever there are generic or bio-equvalent drugs available we willingly try them. Nearly all have been fine and have saved both me and the company money. If they do not work after a reasonable trial, Blue Cross has made exceptions after sufficient documentation.

Similarly, when I wanted a faster nebulizer for my convenience, I didn't expect my insurance company to cover it. But, if I NEED it to dispense a specific drug, I'll fight for it.

Expensive specialty drugs like Brinsupri will need to demonstrate to insurers that they reduce primary medical expenses (like hospitalizations) in order to get onto their formularies or continue be covered.