Navigation Links
New Highmark Policy Threatens Pennsylvania Patients With Primary Immunodeficiency Diseases
Date:3/16/2011

HARRISBURG, Pa., March 16, 2011 /PRNewswire/ -- Beginning April 1, Highmark Blue Cross Blue Shield (Highmark) will force their insured patients with primary immunodeficiency diseases (PIDD) and other rare disorders to switch their prescription to a single brand of immunoglobulin (IgG - a blood plasma product), regardless of their current IgG therapy. Under the new Highmark "formulary," even patients who are successfully being treated with another brand of IgG will have to "fail first" on the new treatment, before being allowed to switch back to their original product. In other words, patients must get ill and suffer possible life-threatening reactions before Highmark will even consider covering another IgG product for that patient. This policy could end up affecting between 1,400 to 2,300 patients in Pennsylvania and 250 patients in West Virginia.

"This is an unconscionable intrusion into the patient and physician relationship that puts vulnerable patients with PIDD at risk," stated Dr. Michael Blaese, Consulting Medical Director of the Immune Deficiency Foundation (IDF). "IgG therapy is a biological treatment that, unlike most prescription drugs, is not generic or interchangeable with IgG produced by different manufacturing processes. In fact, patients can experience a wide range of adverse reactions to one IgG product while tolerating others without problem. Medical literature indicates that up to 34% of patients who switch from one IgG product to another will suffer adverse reactions, including severe and life-threatening reactions. Whereas physicians must do no harm, insurance companies evidently think it is okay."

"Instead of doctors who are experienced in treating PIDD, Highmark now will be making the determination about which IgG therapy will be the most appropriate for patients," added Dr. Blaese.

IDF today launched the "Highmark Is Not My Doctor" campaign to reverse Highmark's April 1 introduction of the new formulary and to generate awareness among physicians, patients, public officials and the public about the potential 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.

"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 plan. We provided reasonable suggestions based on medical evidence that are in the best interest of the patients, yet allow the company to consider costs. But they have yet to make any changes or accept our recommendations," added LaMotte.

IDF has asked that any Highmark policy should:

  • Not determine the specific IgG therapy a patient must use
  • Ensure that patients already stabilized on an IgG therapy not be switched to another therapy without medical cause
  • Allow physicians an opportunity to prescribe an alternative if they determine it is in the best interest of the patient
  • Better inform patients and physicians about its policy plans and gain direct feedback on their recommendations.

For more information about "Highmark Is Not My Doctor", visit the campaign's blog at www.Highmarkisnotmydoctor.com or www.primaryimmune.org.

About the Immune Deficiency Foundation

The Immune Deficiency Foundation is the national patient organization dedicated to improving the diagnosis, treatment and quality of life of persons with primary immunodeficiency diseases through advocacy, education, and research.    


'/>"/>
SOURCE Immune Deficiency Foundation
Copyright©2010 PR Newswire.
All rights reserved

Related medicine technology :

1. Highmarks Collaboration With Hospitals and Doctors Continues to Yield Benefits for all Patients
2. Highmark Study Shows Integrated Medical and Pharmacy Benefits Lower Costs, Promote Better Health
3. Highmark Presents Work on MRSA Prevention at National Health Care Quality Conference
4. PDL BioPharma Announces Regular Quarterly Dividend Policy
5. Lilly CEO Says Industry, Public Policy Must Pave Way For Innovation
6. New FDLIs Food and Drug Policy Forum Focuses on Liability Issues in Vaccine Design Defect Claims
7. FDLIs Food and Drug Policy Forum Examines European GMO Rules
8. Change in Medicare Wheelchair Policy May Prevent Texas Beneficiaries from Receiving Mobility Assistance Starting January
9. Rural Wheelchair Patients Will Be Hit Hard by Power Wheelchair Rental Policy; Providers, Advocates Ask Congress for a Delay
10. K-V Pharmaceutical Company Announces Reliance on Financial Distress Exception to NYSEs Shareholder Approval Policy
11. Congress Urged to Delay New Medicare Wheelchair Rental Policy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... , May 4, 2016 ... addition of the  "Global Acute Ischemic Stroke ...  report to their offering.       ... Global Acute Ischemic Stroke Market and ... into Acute Ischemic Stroke pipeline products, Acute ...
(Date:5/3/2016)... 2016 Global Insulin Needles ... 09 key companies and supported with 272 tables ... study on the current state of the Insulin ... industry including definitions, classifications, applications and industry chain ... for the international market including development history, competitive ...
(Date:5/3/2016)... , May 3, 2016  As a teenager, an ... rheumatic fever, which damaged his heart. He continued enjoying ... by June 2013, Shepherd,s heart was giving out and ... On June 20, 2013, the Mesa, Arizona ... Heart (TAH-t). Like a heart transplant, the SynCardia TAH-t ...
Breaking Medicine Technology:
(Date:5/4/2016)... NY (PRWEB) , ... May 04, 2016 , ... ... non-profit organization devoted exclusively to funding innovative lymphoma research and serving the lymphoma ... ā€“ is set to return to the esteemed Quaker Ridge Golf Club in ...
(Date:5/4/2016)... ... May 04, 2016 , ... Nike Rugby Camp's success is due in large ... founder of Elite Rugby Camps and current Nike Camp director, has offered an all ... , ā€œIā€™m excited for our eighth summer here in San Diego,ā€ says Willis. ...
(Date:5/4/2016)... ... 2016 , ... Washington Wellness Center today announced its tenth anniversary of providing ... started out as an idea to provide a holistic approach to wellness has now ... by Dr. David Swanekamp, Chiropractic Physician , the wellness center offers a complete ...
(Date:5/4/2016)... ... May 04, 2016 , ... Nordic Naturals announces another breakthrough ... health. This synergistic combination of omega-3 fatty acids and potent antioxidants contains 1000 ... reduced glutathione and 200 mg of N-Acetylcysteine (NAC). , Each nutrient plays ...
(Date:5/4/2016)... ... May 04, 2016 , ... The preeminent surgical aftercare ... Dickinson needed following breast cancer surgery. In March 2016, the 61-year-old model and reality ... breast cancer that occurs in the milk ducts, according to an interview with ...
Breaking Medicine News(10 mins):