Complication #0 actually seems even worse when private insurance is tossed in to the mix: much of the monitoring that would be prudent is excluded by my employe

Complication #0 actually seems even worse when private insurance is tossed in to the mix: much of the monitoring that would be prudent is excluded by my employer-based insurance company as "not medically necessary". For example, I can't get them to pay for a CYP2D6 test to determine if I'm an ultrarapid metabolizer of a particular drug, nor can I get them to pay for blood level monitoring of the active metabolite to determine if I'm in the therapeutic range. In fact, tests across cytochrome P450 have a blanket exclusion. This is a $20,000 per year policy; probably the best the US health system has to offer.