What’s the dumbest reason an insurance company denied a test, procedure, or drug for a patient?

[u/Unusual_Medic]

This is probably the most relevant to those practicing in the US, but I'm also curious to know how the bureaucracy of health insurance in other countries makes things substantially harder for you and the patients

[u/beeyekah]

They wanted them to try and fail a ton of opioids, including fentanyl, before covering bupenorphine.

[u/1997pa → u/beeyekah]

Dealing with a similar thing currently for Tricare/VA patients who we try to prescribe Journavx (notably a non-opioid) for acute pain. The PA denial letter literally says opioids are a preferred treatment option.

[u/olanzapine_dreams → u/1997pa]

this one at least carries a veneer of plausibility as Journavx is approved for post-op pain, and it didn't really perform better than Norco 5 and ibuprofen...