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California Minority Advocacy Groups Send Letter to Blue Shield of California Calling for an End to Discriminatory Practice that Denies Patients in Pain Access to Proper Medication
Date:11/20/2009

LOS ANGELES, Nov. 20 /PRNewswire/ -- California minority advocacy groups including Healthy African American Families, The Wall/Las Memorias, Latina Breast Cancer Agency, Black Barbershop Health Outreach Program, and the Real Medicine Foundation today sent a letter to Blue Shield of California calling on the company to reconsider harmful and discriminatory coverage policies.

The letter to Blue Shield specifically calls for an end to the practice of step therapy, which requires patients to fail on up to five medications before Blue Shield will cover the treatment initially prescribed by a doctor. The California minority advocacy groups say that step therapy disproportionately affects minority and low-income communities in California.

"When Blue Shield denies patients access to timely and effective treatment, those who need medicine for chronic pain - including Californians suffering from arthritis, multiple sclerosis, and fibromyalgia - are especially hurt," said Loretta Jones of Healthy African American Families in the letter. "Many in the African American and Latino communities have diabetes, which includes DPN, a painful nerve condition. When Blue Shield requires those suffering from DPN to take medication that does not relieve our pain, more than our quality of life suffers."

"When a mother suffering from DPN is forced to try multiple pain treatments that do not work, she often must miss work, and arrange childcare and travel, which threatens her livelihood and ability to provide for her family," the letter continues. "It is not only unethical, but cruel, for Blue Shield to deny a patient access to a medicine the doctor knows will relieve their pain and to require the patient to go through multiple steps of taking drugs that don't work."

The full text of the letter read:

Dear Mr. Bodaken:

We are writing to ask that Blue Shield of California change a dangerous coverage policy that denies California patients in pain access to critical medication. We are concerned that this practice particularly discriminates against members of California minority and low-income communities.

Blue Shield refuses to initially cover doctor-prescribed and FDA-approved treatments, instead requiring California patients in pain to try and fail on up to five medications before Blue Shield will cover the treatment initially prescribed by a doctor.

The result of this "fail first" policy is that members of minority and low-income communities are denied access to new and better medications, and that they experience prolonged pain and often deteriorating health.

When Blue Shield denies patients access to timely and effective treatment, those who need medicine for chronic pain - including Californians suffering from arthritis, multiple sclerosis, and fibromyalgia - are especially hurt. Many in the African American and Latino communities have diabetes, which includes DPN, a painful nerve condition. When Blue Shield requires those suffering from DPN to take medication that does not relieve our pain, more than our quality of life suffers.

When a mother suffering from DPN is forced to try multiple pain treatments that do not work, she often must miss work, and arrange childcare and travel, which threatens her livelihood and ability to provide for her family. It is not only unethical, but cruel, for Blue Shield to deny a patient access to a medicine the doctor knows will relieve their pain and to require the patient to go through multiple steps of taking drugs that don't work.

The U.S. Centers for Medicare and Medicaid Services (CMS) adopted a policy in March 2009 that prevents health insurers like Blue Shield from requiring patients to take more than two medications before the insurer will cover the medicine that the doctors thinks is the best treatment. In addition, the new CMS regulations prevent health insurers from forcing a patient to take drugs that have not been approved by the FDA when a doctor initially prescribes an FDA-approved drug for the patient's condition.

This new Medicare policy, which goes into effect in January 2010, is an important step to ensure that Medicare patients have access to the treatments they need, when they need it. But Californians who are not covered by Medicare deserve the same protections.

For the reasons stated above, we respectfully request that Blue Shield ceases this harmful "fail first" policy and ensures that California patients in pain do not continue to suffer.

Sincerely,

Loretta Jones

Executive Director

Healthy African American Families II

Bill Releford, M.D.

Black Barbershop Health Outreach Program

Martina C. Fuchs, M.D., Ph.D.

Real Medicine Foundation

Richard Zaldivar

Executive Director

The Wall/Las Memorias Project

Olivia Fe

Executive Director

Latina Breast Cancer Agency

Media interested in speaking with any of the above advocates about step therapy and the impact on minority communities in California should contact Lucila Garcia at (323) 646-2150, or lucilagarcia@rational360.com

About Healthy African American Families II

Healthy African American Families II (HAAF) is a non-profit, community-serving agency whose mission is to improve the health outcomes of the African American and Latino communities in Los Angeles County by enhancing the quality of care and advancing social progress through education, training and collaborative partnering with community stakeholders, academia, researchers, and government. HAAF services all of South Los Angeles and Service Planning Area 6 in particular. HAAF is widely regarded in the community as an advocate voice, and source of education and training around disparities and research, for the local community. HAAF regularly disseminates research to community in its free major yearly events. HAAF's partners include: Charles R. Drew University of Medicine and Science, UCLA, RAND, and over 150 community based organizations.

www.haaf2.org

SOURCE Healthy African American Families


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SOURCE Healthy African American Families
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