[HN Gopher] First UK child to receive gene therapy for fatal gen...
       ___________________________________________________________________
        
       First UK child to receive gene therapy for fatal genetic disorder
       is now healthy
        
       Author : ryzvonusef
       Score  : 188 points
       Date   : 2023-02-17 19:51 UTC (3 hours ago)
        
 (HTM) web link (www.livescience.com)
 (TXT) w3m dump (www.livescience.com)
        
       | dang wrote:
       | Related (somewhat):
       | 
       |  _First gene therapy for Tay-Sachs disease successfully given to
       | two children_ - https://news.ycombinator.com/item?id=30408104 -
       | Feb 2022 (77 comments)
        
       | arpanetus wrote:
       | you can't just simply state that he's healthy without actually
       | seeing his lifespan
        
       | fnordpiglet wrote:
       | I for one welcome our new genetically modified UK child overlord.
        
       | mmaunder wrote:
       | I wonder if a similar approach can be used for Von Hippel Landau.
       | 
       | " Mutations in the VHL gene cause von Hippel-Lindau syndrome. The
       | VHL gene is a tumor suppressor gene, which means it keeps cells
       | from growing and dividing too rapidly or in an uncontrolled way.
       | Mutations in this gene prevent production of the VHL protein or
       | lead to the production of an abnormal version of the protein. An
       | altered or missing VHL protein cannot effectively regulate cell
       | survival and division. As a result, cells grow and divide
       | uncontrollably to form the tumors and cysts that are
       | characteristic of von Hippel-Lindau syndrome."
       | 
       | https://medlineplus.gov/genetics/condition/von-hippel-lindau...
        
       | SamBam wrote:
       | The article was skimpy on the details. Can someone explain how
       | this part works?
       | 
       | > The new gene therapy [...] works by inserting into the body
       | working copies of the genes that are faulty in MLD, thus
       | restoring the ability to break down sulfatides.
       | 
       | How does the new copy of the gene get into every existing cell
       | that needs it? A virus?
        
         | amelius wrote:
         | Also, when cells replicate, will the new ones automatically be
         | of the edited type? Or is it not that simple?
        
           | janeway wrote:
           | That is the goal but not that simple.
           | 
           | In most cases, the original disease-causing stem cells are
           | effectively eliminated by the conditioning regimen (high-dose
           | chemotherapy and/or radiation) used before the (autologous)
           | transplantation, so they do not regenerate and cause further
           | harm to the patient. However, in some cases, residual disease
           | cells may survive the conditioning regimen and persist after
           | transplantation, leading to disease relapse. This is more
           | likely to occur in patients with aggressive or refractory
           | disease or in those who receive a mismatched or
           | haploidentical donor graft. To prevent disease relapse, post-
           | transplantation maintenance therapy, such as
           | immunosuppressive drugs or targeted therapies, may be used to
           | eliminate residual disease cells. Additionally, close
           | monitoring of the patient's blood counts and immune system
           | function can help identify and manage any signs of disease
           | relapse.
        
           | ethanwillis wrote:
           | In general it depends. If you modified existing blood cells
           | genotype then it wont persist indefinitely. You'd need to
           | modify the bone marrow. But then some cell lines work like
           | you posed in your question.
        
           | MaryBall wrote:
           | Because this therapy edits the stem cells that are found in
           | the bone marrow, it essentially means that the disease is
           | being fixed at the source. Bone marrow stem cells eventually
           | turn into blood cells and immune cells. So if 100% of the
           | cells have been edited, then the resulting cells they turn
           | into will be the edited type.
        
         | herlitzj wrote:
         | https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
         | 
         | This paper seems to have more details on the actual procedure
         | 
         | Patients were treated and monitored according to the schedule
         | described in the appendix (p 17) and as previously reported.16,
         | 17 HSPCs harvested from bone marrow or mobilised peripheral
         | blood (MPB) were transduced with clinical-grade lentiviral
         | vector encoding human ARSA cDNA under the control of the human
         | phosphoglycerate kinase gene promoter.
        
         | MaryBall wrote:
         | Yes, you're right! A lentiviral vector is used to insert the
         | working gene into the patient's stem cells. Obviously this is a
         | non-pathogenic version of the virus, so it's ability to make
         | you ill has been essentially "switched off". However the
         | ability for the virus to insert genetic information into the
         | DNA of cells remains.
        
         | bglazer wrote:
         | Yes, it's a virus, specifically a lentivirus, which inserts its
         | own genome into the cells DNA, including the therapeutic gene.
         | Looks like they first extract bone marrow from a patient, apply
         | the virus which adds the gene, then they put the "fixed" bone
         | marrow cells back into the patient (probably after killing most
         | existing bone marrow through some really unpleasant
         | procedures). The re-inserted, treated cells then expand and
         | begin making new cells that have inherited the fixed gene.
         | 
         | In general, gene therapy is probably most useful currently for
         | diseases that affect the bone marrow (and the eyes), because
         | these are two tissues where you can precisely deliver the
         | virus. It's still challenging to control where the virus goes
         | and which cells it infects if you just inject it straight into
         | the bloodstream.
        
           | meese712 wrote:
           | I'm confused how this would reduce disease progression
           | compared to a much cheaper allo bone marrow transplant then
           | if they are only modifying hematopoietic stem cells since a
           | BMT is just doing the exact same thing except with someone
           | else's non affected cells. BMTs are a horrific procedure
           | though so this definitely has an advantage in that regard.
           | 
           | I would also have to imagine they would have to do
           | myeloablative chemo or radiation to make sure the fixed cells
           | propagate more than the diseased cell line.
           | 
           | Edit: read the study, they do give them the same chemo used
           | for normal transplants.
        
             | piyh wrote:
             | Most recipients don't need to take immunosuppressants at
             | all if they get PBSC or bone marrow transplants. Even if
             | they do, it's short term. Additionally, the allo grafts
             | need to be matched, which if you're non white is not a good
             | success rate. 85%ish of whites get matched, that number
             | gets depressingly low for minorites. On the US registry,
             | only 1 in 400 donors get called. I happen to be one of
             | those donors and a system where I'm not needed is a better
             | one. The best part is no part.
             | 
             | https://ashpublications.org/blood/article/104/12/3501/89040
             | /...
             | 
             | >Previous studies have shown that 30% to 70% of all
             | patients surviving beyond 100 days after HCT require
             | treatment for chronic GHVD,2,4-6 often for more than 2
             | years.
             | 
             | Re: a better system is where you don't need donors:
             | 
             | https://www.cbsnews.com/newyork/news/l-i-woman-dies-after-
             | ma...
        
               | meese712 wrote:
               | I was getting at the article giving the impression this
               | somehow cured the disease vs a BMT just slowing
               | progression. I know the whole transplant thing sucks.
               | I've had two transplants, thank you for being on the list
               | :).
        
             | theGnuMe wrote:
             | Well it removes graft vs host complications which is a win
             | and the requirement to take immunosuppressants for life.
        
               | meese712 wrote:
               | Definitely true GVHD sucks. The article gave me the
               | impression that they were saying it was somehow superior
               | at stopping the disease because it said this "stem cell
               | transplants, have sometimes been used to slow the
               | disorder's progression in infants,"
               | 
               | (fyi a decent amount of stem cell transplant survivors do
               | not have to take immunosuppressants for life)
        
               | [deleted]
        
           | fnord77 wrote:
           | > probably after killing most existing bone marrow through
           | some really unpleasant procedures
           | 
           | usually a massive dose of radiation, right?
        
         | Traubenfuchs wrote:
         | In this specific case CRISPR-CAS9 was used to edit
         | "hematopoietic stem and progenitor cells". This means all
         | modified stem cells (sadly not 100% of them) will from now on
         | produce cells with the gene bugfix applied.
         | 
         | This does not imply that germ line cells were changed and COULD
         | mean the person could still have a high risk of making children
         | with the original gene defect.
         | 
         | https://pubmed.ncbi.nlm.nih.gov/34882002/
        
       | ryzvonusef wrote:
       | > Libmeldy is made using stem cells that are derived from a
       | patient's blood or bone marrow and can give rise to different
       | types of blood cells, according to the European Medicines
       | Agency(opens in new tab) (EMA). These stem cells carry the new,
       | functional genes into the body, where they give rise to white
       | blood cells that travel through the bloodstream.               >
       | In clinical trials, Libmeldy offered clear benefits to infantile
       | and juvenile patients who hadn't yet developed MLD symptoms;
       | these patients were able to break down sulfatides at normal rates
       | and showed typical patterns of motor development, for example.
       | The benefit of the therapy seemed to last several years, but at
       | this point, "it is not yet clear whether it will persist life-
       | long, and extended follow-up is needed," the EMA noted.
       | > Libmeldy is approved for use in the European Union and U.K.,
       | although the U.K.'s drug price watchdog initially rejected the
       | therapy due to its hefty list price of PS2.8 million ($3.4
       | million at today's exchange rates), BBC News(opens in new tab)
       | reported in 2022. The therapy's manufacturer, Orchard
       | Therapeutics, then offered Libmeldy to the NHS at a significant
       | discount.              > The gene therapy has not yet been
       | approved by the U.S. Food and Drug Administration(opens in new
       | tab).
        
       | jiggawatts wrote:
       | https://en.m.wikipedia.org/wiki/Atidarsagene_autotemcel
       | 
       | > The National Centre for Pharmacoeconomics (NCPE) in Ireland
       | recommends "that atidarsagene autotemcel not be considered for
       | reimbursement unless cost effectiveness can be improved relative
       | to existing treatment."
       | 
       | Wow... instead of a lifesaving cure they recommend the treatment
       | of the symptoms until the kid dies because it's _cheaper_.
        
         | sho_hn wrote:
         | People are often surprised by this, but healthcare and
         | insurance systems assign an explicit numerical value to human
         | lives and run with it all the time.
         | 
         | https://en.wikipedia.org/wiki/Value_of_life
        
         | xxpor wrote:
         | The world doesn't have unlimited resources. You have to make a
         | call somewhere.
        
           | elil17 wrote:
           | Governments and non-profits already funded the development of
           | gene therapy. Letting private companies charge money for it
           | and then blocking people who need it from getting it is a
           | policy decision.
        
             | whiddershins wrote:
             | Doing the procedure has a cost. There must be some pressure
             | to reduce the cost, else it will never reduce.
        
               | elil17 wrote:
               | I agree there needs to be pressure. Why not regulatory
               | pressure?
        
               | sn0wf1re wrote:
               | What sort of regulation? Make it cheaper by x% per year
               | or we stop using it? Doesn't sound that dissimilar to
               | "make it cheaper than the total cost of the current
               | treatment or we won't use it".
        
               | elil17 wrote:
               | I'd just change the "or we won't use it" to "or your
               | patents go away."
        
               | pc86 wrote:
               | And then instead of reading "that atidarsagene autotemcel
               | not be considered for reimbursement unless cost
               | effectiveness can be improved relative to existing
               | treatment" today, we would have read something like
               | "current regulatory environment precludes research and
               | development expenditures into atidarsagene autotemcel" in
               | some biopharm prospectus a decade ago.
               | 
               | You can't have it both ways and preventing people from
               | making money means, not surprisingly, they will be very
               | hesitant to spend money researching those areas.
        
             | krona wrote:
             | In quality-adjusted life years (QALYs), there is an upper
             | limit to the cost of any intervention because the most you
             | can save from one intervention is one life. If the same
             | money can be used to substantially improve the lives of 100
             | people with other interventions, then the cost-utility
             | analysis may say a particular intervention is not
             | effective.
             | 
             | You might not like the utilitarian approach but this is how
             | the UK measures effectiveness.
        
               | elil17 wrote:
               | I do like the utilitarian approach, I just think
               | sometimes you need to look outside the box of do A or
               | don't do A. If the only options were pay for the
               | treatment or don't, then Ireland might be making the
               | right call by not paying for it.
               | 
               | Ireland could simply let a local company violate the drug
               | patents. A country like the UK could impose conditions
               | such as profit caps on pharmaceutical companies who base
               | their work on publicly funded research. We could reduce
               | the length of drug patents. There are many, many options
               | besides "role over and let pharma companies charge $4
               | million/treatment when it costs them $1 million."
        
               | ericd wrote:
               | From the article: "Libmeldy is approved for use in the
               | European Union and U.K., although the U.K.'s drug price
               | watchdog initially rejected the therapy due to its hefty
               | list price of PS2.8 million ($3.4 million at today's
               | exchange rates), BBC News (opens in new tab) reported in
               | 2022. The therapy's manufacturer, Orchard Therapeutics,
               | then offered Libmeldy to the NHS at a significant
               | discount."
               | 
               | So it does seem like they've already discounted it
               | heavily.
        
               | ifdefdebug wrote:
               | Utilitarian cynism at its best.
               | 
               | The humanitarian approach is to save that one live AND
               | improve the other 100 as well. We can afford to do so,
               | because those expensive cases are rare.
        
               | lazyasciiart wrote:
               | They really aren't that rare, and the reason we don't
               | help all of them is not because of a _utilitarian_
               | decision not to spend money on public healthcare. If you
               | can get your humanitarianism to move that money from corn
               | subsidies and fighter jets to health spending, more power
               | to you.
        
               | fshbbdssbbgdd wrote:
               | If the cost isn't reflective of real resource/labor
               | consumption, but instead is a rent on IP (which is
               | partially repaying some fixed R&D investment), it's not
               | so simple.
               | 
               | Let's suppose a drug company is setting their price to
               | maximize revenue.
               | 
               | Suppose they make the following projections:
               | 
               | They determine that if the treatment price is $10 million
               | above the actual cost of providing the treatment, 5
               | people will buy it. $50 million total profit.
               | 
               | If the price is set so the profit per treatment is $1
               | million, 100 people will use it. $100 million total
               | profit.
               | 
               | If the profit per treatment is $100k, 800 people will use
               | it. $80 million total profit.
               | 
               | If the company isn't factoring in the value of a life
               | saved, they will pick the $1 million price point. If
               | ethicists then just run with that price, they may come to
               | the conclusion that the treatment isn't cost-effective.
               | However, they are relying on data that's an output of a
               | process with conflicting values, and that pollutes the
               | result of their calculation. Garbage in, garbage out. The
               | 700 people who didn't get treated lose out for a pretty
               | bad reason.
               | 
               | We could imagine a policy where the drug companies are
               | mandated to maximize lives saved when setting prices. One
               | might argue that companies won't develop as many drugs if
               | profits can't be maximized. We could adjust the policy to
               | subsidize companies for income lost when setting lower
               | prices. Ie. if the drug company picks the $100k price
               | point to save 700 more lives, the government gives them
               | $20M compensation so they can profit like they would have
               | at the $1M price point. That way society spends the same
               | amount of money on this drug, but more lives get saved.
               | I'm sure there's a lot of challenges in designing a
               | program like that, but the opportunity to save lives
               | makes it seem worthwhile to attempt.
        
           | theGnuMe wrote:
           | There's certainly enough resources for this and any medical
           | treatment.
        
           | shadowgovt wrote:
           | There are, on the high end of the estimate, 1,600 kids in the
           | UK that might have this disease. It's estimated about 5 are
           | born per year.
           | 
           | I suspect we can somehow find enough pennies in the couch
           | cushions to get those kids a therapy, especially if it's
           | curative.
        
             | gambiting wrote:
             | The problem is, as always, with allocation of resources. If
             | you are running NHS budgets and these treatments cost PS1M
             | each(we don't know what price was agreed in the end, but
             | let's say it's PS1M per treatment), that's PS1.6 billion to
             | treat 1600 kids. PS1.6 billion is a lot of money that can
             | save a lot of more than 1600 people if used for other
             | therapies. It's a horrible choice to make of course, but
             | it's the reality of it. Yes of course the government and
             | the country has enough money to afford it - but NHS is
             | given a fixed budget.
        
               | linuxftw wrote:
               | That would imply that people are dying right now due to
               | NHS rationing resources, which NHS will never admit to.
        
               | gambiting wrote:
               | Well no, but it could be used to(for example) shorten the
               | ambulance waiting time, and that alone would save more
               | than 1600 people.
        
               | [deleted]
        
               | kiba wrote:
               | That assume the technology never gets cheaper over time.
               | I would hope it gets better over time as we cure more and
               | more rare diseases.
        
         | vkou wrote:
         | > Wow... instead of a lifesaving cure they recommend the
         | treatment of the symptoms until the kid dies because it's
         | cheaper.
         | 
         | That's the same sort of ethical calculus that goes into
         | deciding the distribution of any life-saving resources.
         | 
         | We can always spend more (resources/social capital) to save
         | more lives/years of life. How do you decide where that line
         | gets drawn?
         | 
         | Most medical systems decide it by looking at the cost of
         | treatment (Dollars, organs, risks), and quantifying years of
         | quality life gained. If you'd like that bar raised, increase
         | the tax rate/insurance costs.
         | 
         | 'Save every life at any cost' is not compatible with a world
         | where you have decide whether your budget goes on a low-ROI, or
         | a high-ROI intervention. 'First come-first-serve' is not
         | compatible with a world where you are optimizing for _overall_
         | positive outcomes.
         | 
         | Do you have any alternative guiding principle for where money
         | in the healthcare system should be spent?
        
         | Nicksil wrote:
         | https://en.wikipedia.org/wiki/Atidarsagene_autotemcel
        
         | cameronh90 wrote:
         | What if the cost was $100 trillion?
        
           | shadowgovt wrote:
           | Its sticker price is actually $3.8 million. At that price, it
           | could be administered to every child in the UK with the
           | disease at about the cost of 1 year of the UK's defense
           | budget.
        
             | Waterluvian wrote:
             | The thing that tires me about this old chestnut is that
             | it's just a shell game and not actually a substantive idea.
             | "Just take money from somewhere else." It's akin to saying
             | that we will use the latest AI technology and machine
             | learning to make our value proposition work. It sounds
             | satisfying but it says nothing.
        
               | CraigJPerry wrote:
               | Why would you need to take money from somewhere else?
               | This is misunderstanding how money works for a currency
               | issuer.
        
               | Waterluvian wrote:
               | Lol exactly. "Just print more money!"
        
             | Gordonjcp wrote:
             | It's probably cheaper if you're buying it in that sort of
             | quantity. Three million quid on this, three million quid on
             | that, three million quid over there, soon you're talking
             | about a lot of money.
             | 
             | If you buy 1600 doses of it at a time they're going to
             | sharpen the pencil for you.
        
             | mrtksn wrote:
             | What happens if UK requires defense that year?
        
         | hummus_bae wrote:
         | Another country where nationalized healthcare is a bad idea.
        
           | shadowgovt wrote:
           | Not sure I follow. It's not like a therapy with a sticker
           | price of $3.8 million is more available in countries without
           | nationalized healthcare.
        
           | mrtksn wrote:
           | In Europe they have these things called planes, it's like a
           | tube you enter and sit for a few hours and once exit you are
           | in a driving distance to American hospitals where you can pay
           | and receive the same treatment as everyone else without
           | nationalised healthcare.
           | 
           | Best of the both worlds.
        
             | gambiting wrote:
             | What's more, Europe also has these private hospitals which
             | aren't connected to the national healthcare system and
             | which will provide you with top level care if you are
             | willing to pay, no travel to US necessary. Private health
             | insurance ( _gasp!_ ) is also a thing, should you want to
             | partake in that system.
        
           | blibble wrote:
           | I think you'll find most insurance policies have a maximum
        
           | nivenkos wrote:
           | But healthcare isn't nationalised in Ireland. Was that your
           | point?
        
         | ls612 wrote:
         | [flagged]
        
           | OscarTheGrinch wrote:
           | I think a full time caregiver of someone incapacitated should
           | have the power to vote on their behalf. This is a big chunk
           | of society, yet seemingly invisible to politicians. Perhaps,
           | if people with disabilities and illnesses couldn't be just
           | ignored as "non voters" they would be more of a priority.
        
             | gambiting wrote:
             | But....they can? You can give someone else the power to
             | vote on your behalf if you cannot do it yourself. Unless
             | you mean that if someone is literally unable to make any
             | decisions by themselves their caretaker should be able to
             | vote on their behalf how they think this person would vote?
             | That doesn't strike me as a very reasonable system, you
             | can't know how someone would vote unless they tell you, and
             | to assume you can or should know is irresponsible.
        
           | gambiting wrote:
           | That's such a reductive, dismissive take on the issue it's
           | actually offensive towards everyone in this country trying to
           | make the healthcare system work. The government isn't ran by
           | some cartoon villains, and the resources at NHS's disposal
           | are finite - I certainly don't envy anyone whose job it is to
           | make sure they are allocated in the most efficient way that
           | also saves the most lives.
        
             | A4ET8a8uTh0 wrote:
             | << The government isn't ran by some cartoon villains
             | 
             | I will make a short quip here. All cartoon villains I saw
             | appear to be fairly capable administrators. If government
             | was ran by one of those, we would likely see an
             | improvement. I am not sure who is in charge anymore, but I
             | can agree with you that it is not cartoon villains.
        
             | wellanyway wrote:
             | But caaapiiitaliiism
        
         | robocat wrote:
         | > because it's cheaper.
         | 
         | Compromises _always_ have to be made because the world does not
         | have infinite resources. Unfortunate, but true.
         | 
         | One way to allocate resources between all our competing needs
         | is by using money.
         | 
         | You can come up with other systems of allocation, however all
         | systems will be unfair and arbitrary in surprising ways. There
         | is always a need to choose between ugly choice A and ugly
         | choice B, because our resources are constrained.
        
         | timerol wrote:
         | Here's the study: https://www.ncpe.ie/wp-
         | content/uploads/2021/04/Libmeldy-Bene...
         | 
         | It's worth mentioning that the study in Ireland indicates that
         | the treatment extends life by 14.49 QALYs (average "Total Life-
         | years" moved from 8.92 to 22.74), which is a long way from a
         | cure. If this is truly a cure, and the treated population lives
         | a full life (life expectancy in Ireland is current 82 years,
         | not 23), then this treatment will become cost effective without
         | any change in the treatment or it's cost. The posted article
         | agrees that this is the big open question.
         | 
         | > The benefit of the therapy seemed to last several years, but
         | at this point, "it is not yet clear whether it will persist
         | life-long, and extended follow-up is needed," the EMA noted.
        
           | jiggawatts wrote:
           | They _can 't possibly_ know that the drug extends life to
           | "22.74" years, because it has only been approved for use for
           | the last 3 years! This is like asking for 30 years of
           | Kubernetes experience on a job application.
           | 
           | Even if the estimate is accurate, there is a massive
           | _qualitative_ difference between slowly dying horribly for
           | 'x' years and living a normal life for 'y' years. You can't
           | just subtract 'x' from 'y' and come up with a delta and
           | compute based on that.
           | 
           | Reminds me of the studies that showed that Tamiflu is
           | ineffective because it only reduced the _duration_ of
           | influenza symptoms by 1 /2 a day on average. Yes, that's
           | true, I've taken it myself and the symptoms continued for
           | about the normal period of time. But it reduces the
           | _severity_ massively. It 's like a light switch. The most
           | severe flu suddenly turns into the mildest of mild cold-like
           | symptoms in a matter of hours. But... that's hard to measure
           | objectively, so it is not recommended because the according
           | to a metric that doesn't matter it doesn't work.
           | 
           | The statistics and metrics in medical papers are _woeful_ ,
           | which is why it's commonly accepted that 1/2 of all medical
           | research is false.
        
         | [deleted]
        
         | themaninthedark wrote:
         | And this in turn leads people to be against national health
         | care as they are worried that the government will be the one
         | making the decision that it is cheaper to let people die rather
         | then treat them.
        
           | Gordonjcp wrote:
           | As opposed to insurance companies making the decision that it
           | is cheaper to let people die than potentially adversely
           | affect shareholder value by treating them?
        
           | ryeights wrote:
           | Such power is already vested in undemocratically governed
           | private insurance companies, no? I can't imagine any health
           | insurance plan would have covered this treatment.
        
           | TSiege wrote:
           | Except that reality is you vote for government, not for the
           | health insurance industry
        
           | CommanderData wrote:
           | Don't some insurers outright deny cover for chronic or
           | genetic conditions?
        
             | vondur wrote:
             | People tend to react differently when the learn it's a
             | government bureaucrat making decisions on healthcare.
             | However, people will also howl when they find out it the
             | decision from a cruel penny pinching CEO. These are really
             | difficult problems. How much is too much to save a life?
        
             | csours wrote:
             | Yes, someone somewhere will be making this decision. It
             | could be insurance, a doctor, nurse, hospital
             | administrator, or family member, or even the affected
             | individual.
        
             | nradov wrote:
             | In the US, medical insurers are not allowed to deny
             | coverage for chronic or genetic conditions due to the
             | Genetic information Nondiscrimination Act of 2008 (GINA)
             | and the Affordable Care Act of 2010 (Obamacare). Some
             | treatments may require proof of medical necessity, or
             | require that providers and patients try lower cost options
             | first (step therapy).
             | 
             | Rules for life insurers are different and in some
             | circumstances they may deny coverage.
        
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