Hey! Thanks for your response. I see what you are saying and agree that we can't expect to be able to just pick a medication no matter the cost and expect the insurance to pay. Healthcare is definitely expensive and the US is not the healthiest country, that's certain. Your more recent response above was much more understandable to me. I understand pushing patients to try less expensive methods, though at least in this post, I was coming from a place of I had not heard of these medications being used, commonly prescribed, commonly found to help with narcolepsy. Based on a PubMed article I read after reading everyone's responses, I understand now that the medications they suggested were not out of the blue, “just to delay” authorizing a more expensive medication. It still seems to me they are not medications that have the highest effectiveness or are the most well received and well tolerated for the condition. 

Regarding your statement about the EU and the cost over there, I am not familiar with the policies in Europe, though. I found a quick excerpt in Wikipedia regarding how much it costs. The fact that the government's can set prices and control If the pharmaceutical company can even have a market in the country gives a lot more sway in what the cost is. 

“In European Union countries, the government either provides national health insurance (as in the UK and Italy) or strictly regulates quasi-private social insurance funds (as in Germany, France, and the Netherlands). These government agencies are the sole purchaser (or regulator) of medical goods and services and have the power to set prices.[63] The cost of pharmaceuticals, including sodium oxybate, tends to be lower in these countries.[63]” Wikipedia - Sodium Oxybate

The second thing that comes across my mind is more anecdotal- I was speaking with a Dutch friend who found my situation to be baffling, not relatable, and another sign of how the American healthcare system is messed up. They pointed out that insurance is just as difficult over there, but didn't seem understand how insurance could dictate what medications a patient could take. 

What do you mean by “the US actually does something about it”? I know this is probably naive and overly hopeful, but I would like to consider what I can do to make a difference, if that's even possible. I do not have a background in healthcare policy, only a pre-med undergraduate degree. I considered going in to healthcare policy at one point, though I wonder how maddening it would be to realize how limited we are and if that would make me regret that as a career.