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Despite New Changes, Highmark Policy Still Threatens Patients With Primary Immunodeficiency Diseases
Date:3/21/2011

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"Late last week, Highmark indicated that it is prepared to provide exemptions of its single therapy requirement for children currently stable on 'non-preferred' products and for patients with a history of intolerable adverse reactions when switched. But, using figures provided by Highmark, they know that this ignores 85% of the affected patient base, the adults with primary immunodeficiency diseases," added Dr. Blaese. "Why should these adult patients be forced to go back and fail on a new therapy, when they are already stabilized?"

"And, what happens to 17 year-olds who turn 18 in a few months?  Will they now be penalized for becoming an adult?" added Dr. Blaese. "Even with the newer Highmark revisions, they may need to switch to a different therapy and risk adverse reactions, even though they've been stabilized for years. And this is hoisted onto them just at the time in their lives when they graduate high school, seek new careers, go to college and face other major transitions."

Last week, IDF launched the "Highmark Is Not My Doctor" campaign with the goal of reversing Highmark's April 1 introduction of the new formulary and to generate awareness among physicians, patients, policymakers and the public about the harmful effects of this action. The campaign includes a blog site, www.HighmarkIsNotMyDoctor.com, to provide information about primary immunodeficiency disease and to educate patients and physicians about the new formulary and what to do to join in the opposition.

"Doctors should decide which therapy is best for a patient's health, not Highmark. 'Failure first' medicine should never be an option when treating a patient – this is a terrible precedent that Highmark is setting and totally unnecessary, stated Lawrence A. LaMotte, Director of Public Policy at IDF. "For the past several months, we have talked to Highmark about the need to reconsider this draconian pla
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SOURCE Immune Deficiency Foundation
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