Doctor calls life-changing stem cell treatment a ‘win-win’ for patients and insurance companies

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CHICAGO, Ill.– A doctor who performs stem cell transplants for people with debilitating diseases calls the procedure a “win-win” for both the patient and their insurance provider.

For the past 30 years, Dr. Richard Burt with Northwestern Memorial Hospital in Chicago, has been researching stem cell transplants.

“We certainly are seeing results that nobody else has seen before,” Dr. Burt said. “We had people that have gone to major medical centers around the country and it’s just more of the same. They continued to decline and they come to us and get a transplant and they get off all therapy and they just get better and better.”

Cory Smallegan, from Grand Rapids, said he was one of Dr. Burt’s patients.  He says that he’s been given a second chance at life due to the transplant.

“A month or so later, I was running and climbing up stairs and doing all sorts of things I couldn’t do before,” Smallegan said.

Smallegan was diagnosed with chronic inflammatory demyelinating polyneuropathy in 2011.  It’s a rare neurological disorder that causes progressive weakness in the arms and legs. Prior to the transplant, he said he was making arrangement to live his life from a wheelchair.

“My legs just couldn’t lift up. Normal people can stand on their toes, I couldn’t do that,” Smallegan said. “I would fall…I would run into things.”

Lori Mills was also diagnosed with CIDP. She’s in the process of seeing Dr. Burt for treatment.

“I got to the point where I was paralyzed–couldn’t move at all,” she said.

In order to get the transplant, a patient first needs to have their diagnoses confirmed by Dr. Burt. He then gives them a one-time treatment that nearly wipes out their immune system. They’re then infused with their own stem cells, which rapidly regenerates a new immune system that functions how it’s suppose to.

“We’re able to reverse disability,” Dr. Burt said.

The only problem is, health insurance providers don’t always cover the procedure. While Blue Cross Blue Shield has agreed to cover Mills’ transplant, Smallegan is now more than $125,000 in debt because BCBS denied him coverage, stating the transplant was a “clinical trial.”

Without the treatment, Mills and Smallegan said they’d both be on IVIg treatments and steroids for the remainder of their lives. Not only do they say those treatments did little to make them better, they said it was expensive, costing BCBS nearly $40,000 a month.

Smallegan, who’s no longer on any treatments, said he’s saved BCBS big money.

“Blue Cross has now saved $1.2 million alone not paying for my treatments,” he said.

Dr. Burt told FOX 17 that getting insurance to cover the procedure is a process. That the medical effectiveness of the treatment has to be proved through published data, which he’s working on. In the meantime, he said stem cell transplants are helping countless patients with various diseases, such as, multiple sclerosis and crohn’s disease.

“I have no doubt that it’s a win-win. It’s a win for the insurance company because it saves money capered to continuing IVIg or plasma feresis,” Dr. Burt said. “It’s a win for the patient because they don’t have to have all these other therapies and they get better.”

FOX 17 reached out to Blue Cross Blue Shield to learn why some patients are covered when it comes to the procedure when other’s are not. They haven’t returned the calls and emails by Monday.

Mills is going through the process of having the stem cell transplant.

“I’ll get that shot again,” she said. “I’m just excited at the whole new shot at life.”

 

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9 comments

  • Wayne

    Thank you for the excellent article. Dr. Burt treated me with HSCT one year ago. It saved me from aggressive MS when expensive drugs with horrible side effects wouldn’t. HSCT also got me out of a wheelchair. Unfortunately, Blue Cross Blue Shield has refused to pay for my HSCT, so I was forced to sell my house and self pay. It was my money or my life, and it was worth it. I now have a case pending in federal court to try and get BCBS to pay. My not being on MS drugs or plasmapheresis anymore is saving BCBS over $150,000 a year. It boggles my mind that they are fighting me on this.

  • Donna Hightower

    I’m alive and well, Thank you Dr. Burt! I’m in the group that BCBS denied to pay for my treatment for aggriessive CIDP. I suffered from my disease and the denial and harassment from BCBS.i I was totally paralazed while BCBS executives enjoy their families and luxuray vacations. BCBS you said, ” IT WONT WORK” , IT DID!!
    You save thirty -five thousand a month on my Ivig treatments which were not working! If it were your loved one stricken down with an awful disease, you’d change your rotten policy. DR. BURt YOU GAVE ME MY LIFE BACK! YOU ARE MY HERO! We need a good lawyer and start a class action lawsuit against BCBS! STEM CELL WORKS BABY!!!!!

    • marty k

      Donna,
      I’m trying to raise money for my son. I am saddened with insurance. They are not making good business sense.
      I wish I knew what to do!.
      Marty

  • ethanndomsmom

    I was diagnosed with MS over 10 years ago. I can no longer walk and am talking to my Doctor about starting my 4th treatment. It would be awesome to go back 8 years to the post-pregnancy relapse that my dr didn’t treat, resulting in the loss of use of my legs. I can’t do that so if we could afford a stem cell transplant it could be the next best thing! My insurance company paid for over 7 years of Tysabri, I think it costs less for the transplant!

  • Anonymous

    I believe that the insurance companies are a big part of the problem. However, if Dr Burt really wanted to make more of an impact, then perhaps he would be trying to do something about the insane hospital costs which inflate the procedure price. It’s well known that health care quality vs cost is low compared to many other countries. This has been the case for a long time yet nothing is being done:
    http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror