Why is her doctor not handling the appeal? My doctor has always handled my drug appeals with a letter of medical necessity, provides my medical records and participates in a peer-to-peer-review with the insurance company. She lays out why I need a specific drug, that I have already been successfully treated on a drug, that other drugs have not worked, that it would be detrimental to my treatment to switch etc. I don’t understand why the pharmacist is handling this for her. My son has epilepsy - same thing: his neurologist handles his drug appeals when he needs prior authorization or when something is denied. It doesn’t make any sense that they do this every year to her and you’re right - each time she is off it, there is no guarantee when she goes back on that it will work. I hope she can get it approved and figure out a way to get it every year with no lapse.