The Brian Lehrer Show Private Insurers Cover Drugs Less Often Now
Jul 31, 2025
Sarah Kliff, an investigative health care reporter for The New York Times, delves into the alarming rise in prescription drug claim denials by private insurers. She highlights a staggering 25% increase in denial rates from 2016 to 2023, sharing personal stories of patients battling to access essential medications like asthma inhalers and diabetes treatments. Kliff explains the complex role of pharmacy benefit managers and stresses the importance of patient advocacy in navigating insurance challenges and appealing denied claims.
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Surge in Drug Denials
- Private insurers have increased prescription drug claim denials by 25% from 2016 to 2023.
- Many denials get resolved but indicate growing barriers between prescription and patient access.
Denial Focus On Specific Drugs
- Denials rose notably for asthma inhalers and weight loss drugs like Ozempic.
- Insurers often deny coverage to push substitutions or limit access to expensive medications.
Patient Pushback Can Work
- Joyce, 67 and immunocompromised, was denied coverage for her effective asthma inhaler.
- After multiple calls and contacting her congressman, she successfully got coverage for the generic inhaler.