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Mass. woman diagnosed with Alzheimer's in 30s told 'too young' for drug by insurance
Wellpoint reversed its initial denial of donanemab after public appeals; drug maker Eli Lilly states it can reduce amyloid plaque by up to 84% in mild dementia cases.
- Wellpoint Insurance approved the Alzheimer's medication donanemab for Massachusetts resident Haritha Sudanagunta, reversing earlier denials that cited her age as a barrier to treatment.
- After Sudanagunta received a devastating Alzheimer's diagnosis in her 30s, Dr. P. Monroe Butler recommended donanemab, but Wellpoint Insurance repeatedly denied the request, stating "she was too young for the drug."
- Robert MacLean noticed Wellpoint's 60-to-85 age requirement matched clinical trial participants, not FDA approval criteria. The drug costs $32,000 annually and targets amyloid plaque to slow disease progression.
- After MacLean contacted his employer's benefits manager and elected officials, Wellpoint reversed the decision without explanation. A spokesperson stated they are "committed to supporting her to the full extent of her coverage."
- Sudanagunta and MacLean are now speaking out to encourage policy changes, arguing that age limits are arbitrary and the insurance appeal process remains broken for patients seeking necessary care.
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