(BPT) – It is almost time to ring in the New Year, which means it is an opportune time to focus on your health and wellness. If you or a loved one is living with cardiovascular disease (CVD), you may be dealing with many burdens, including access to medications — an increasingly common problem.
When prescribed a medication by a physician, most individuals expect to receive the medication without jumping through hurdles. However, for many people affected by cardiovascular disease across the country, this is increasingly not always the case. According to Symphony Health Solutions, commercial payers deny up to 90 percent of initial claims submissions for patients with CVD, with the final rejection rate for patients at 73 percent.
Many of these patients who are rejected have high cholesterol and/or familial hypercholesterolemia (FH), which is an inherited form of significantly high cholesterol and one of the most common genetic diseases, affecting at least one in every 200 to 500 people. Thus, these patients are exploring new treatment regimens because they have not been able to get their low-density lipoprotein cholesterol (LDL-C), or “bad” cholesterol, under control despite treatment with a statin — the current standard of treatment. Additionally, many patients living with atherosclerotic cardiovascular disease (ASCVD), which is caused by a build-up of cholesterol-rich plaque in the arteries, are unable to get their LDL-C under control with current treatment options.
With CVD being a major public health concern in the U.S, it is imperative to lower bad cholesterol for patients who have already had a cardiovascular event, like a heart attack or stroke, as well as patients with FH who require additional treatment options to lower their LDL-C levels along with their statin. Yet, there is a growing concern that many patients with uncontrolled LDL-C levels continue to face challenges in accessing PCSK9 inhibitors their physicians have prescribed based on the approved indication. PCSK9 (or proprotein convertase subtilisin/kexin type 9) inhibitors are human monoclonal antibodies that block the protein PCKS9, which prevents the body’s natural system from eliminating “bad” cholesterol (low-density lipoprotein cholesterol or LDL-C) from the blood.
While the U.S. Food and Drug Administration carefully determined which patients would be appropriate for PCSK9 therapy given the clinical trial information, many payers have implemented restrictive prior authorization processes using stringent utilization management criteria, which is resulting in many patients being denied access. This is not unique to PCSK9s though; we have seen these restrictive authorization practices affecting patients seeking Hepatitis C and heart failure treatments as well.
Being denied access to the medicine you are prescribed is tremendously frustrating and can leave patients feeling hopeless. However, it is important to know that, as a patient, there are certain things you can do to take action if this happens to you:
* Talk to Your Doctor: If you are denied access to vital treatment, talk with your physician about what you can do to receive the therapy you need.
* Share Your Story: Patients and physicians should feel empowered to speak out and engage with their networks, sharing their stories to help drive attention and awareness to the issue.
* Engage Advocates: Seek out advocacy groups and patient networks that have resources.
Make your health a priority for 2017. If you (or a loved one) suffers from CVD, make sure to talk to your physician — or encourage your friends and family — to ensure you or a loved one are receiving the appropriate medical care. For more information, visit www.advancecardiohealth.org.
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[youtube https://www.youtube.com/watch?v=kuW9dPM43GU&fs=1&rel=0]
* Learn more from http://skinome.com/index?utm_source=y Facebook COO Sheryl Sandberg UC Berkeley Commencement Speech 2016 “What I Learned from Death of My Husband, Dave Goldberg.” I am deeply moved by her speech. I sincerely hope she is doing well. She is a truly role model for women. 《向前一步》作者雪莉·桑德伯格加州大学伯克利感人的毕业演讲“丧夫之痛，让我坚强”
Today will be a bit different. We will still do the caps and you still have to do the photos. But I am not here to tell you all the things I’ve learned in life. Today I will try to tell you what I learned in death.
I have never spoken publicly about this before. It’s hard. But I will do my very best not to blow my nose on this beautiful Berkeley robe.
One year and thirteen days ago, I lost my husband, Dave. His death was sudden and unexpected. We were at a friend’s fiftieth birthday party in Mexico. I took a nap. Dave went to work out. What followed was the unthinkable—walking into a gym to find him lying on the floor. Flying home to tell my children that their father was gone. Watching his casket being lowered into the ground.
For many months afterward, and at many times since, I was swallowed up in the deep fog of grief—what I think of as the void—an emptiness that fills your heart, your lungs, constricts your ability to think or even to breathe.
Dave’s death changed me in very profound ways. I learned about the depths of sadness and the brutality of loss. But I also learned that when life sucks you under, you can kick against the bottom, break the surface, and breathe again. I learned that in the face of the void—or in the face of any challenge—you can choose joy and meaning.
I’m sharing this with you in the hopes that today, as you take the next step in your life, you can learn the lessons that I only learned in death. Lessons about hope, strength, and the light within us that will not be extinguished.
A few weeks after Dave died, I was talking to my friend Phil about a father-son activity that Dave was not here to do. We came up with a plan to fill in for Dave. I cried to him, “But I want Dave.” Phil put his arm around me and said, “Option A is not available. So let’s just kick the shit out of option B.”
We all at some point live some form of option B. The question is: What do we do then?
Finding gratitude and appreciation is key to resilience. People who take the time to list things they are grateful for are happier and healthier. It turns out that counting your blessings can actually increase your blessings. My New Year’s resolution this year is to write down three moments of joy before I go to bed each night. This simple practice has changed my life. Because no matter what happens each day, I go to sleep thinking of something cheerful. Try it. Start tonight when you have so many fun moments to list— although maybe do it before you hit Kip’s and can still remember what they are.
Last month, eleven days before the anniversary of Dave’s death, I broke down crying to a friend of mine. We were sitting—of all places—on a bathroom floor. I said: “Eleven days. One year ago, he had eleven days left. And we had no idea.” We looked at each other through tears, and asked how we would live if we knew we had eleven days left.
As you graduate, can you ask yourselves to live as if you had eleven days left? I don’t mean blow everything off and party all the time— although tonight is an exception. I mean live with the understanding of how precious every single day would be. How precious every day actually is.
But I am also aware that I am walking without pain. For the first time, I am grateful for each breath in and out—grateful for the gift of life itself. I used to celebrate my birthday every five years and friends’ birthdays sometimes. Now I celebrate always. I used to go to sleep worrying about all the things I messed up that day—and trust me that list was often quite long. Now I try really hard to focus on each day’s moments of joy.
It is the greatest irony of my life that losing my husband helped me find deeper gratitude—gratitude for the kindness of my friends, the love of my family, the laughter of my children. My hope for you is that you can find that gratitude—not just on the good days, like today, but on the hard ones, when you will really need it.
There are so many moments of joy ahead of you. That trip you always wanted to take. A first kiss with someone you really like. The day you get a job doing something you truly believe in. Beating Stanford. (Go Bears!) I hope that you live your life—each precious day of it—with joy and meaning. I hope that you walk without pain—and that you are grateful for each step.
Class of 2016, as you leave Berkeley, build resilience. Congratulations, and Go Bears!
Sheryl Sandberg UC Berkeley Commencement Speech 2016 What I Learned from Death桑德伯格加州大学伯克利毕业演讲
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