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:6/24/2016)... , June 24, 2016   Pulmatrix, Inc ., ... developing innovative inhaled drugs, announced today that it was ... Investments reconstituted its comprehensive set of U.S. and ... "This is an important milestone for Pulmatrix," said Chief ... shareholder awareness of our progress in developing drugs for ...
(Date:6/23/2016)... , June 23, 2016 Research and ... Global Market - Forecast to 2022" report to their ... treatment method for the patients with kidney failure, it replaces ... fluid from the patient,s blood and thus the treatment helps ... and chloride in balance. Increasing number of ...
(Date:6/23/2016)... 23, 2016 Roche (SIX: RO, ROG; OTCQX: ... its Elecsys BRAHMS PCT (procalcitonin) assay as a dedicated ... shock. With this clearance, Roche is the first IVD ... solution for sepsis risk assessment and management. ... and PCT levels in blood can aid clinicians in ...
Breaking Medicine Technology:
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... Oklahoma (PRWEB) , ... June 25, 2016 , ... ... both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures ... Oklahoma City area —Johnson is one of the first doctors to perform the ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
(Date:6/24/2016)... ... ... Global law firm Greenberg Traurig, P.A. announced that 20 Florida attorneys are ... for this recognition are considered among the top 2 percent of lawyers practicing within ... of this year’s Legal Elite Hall of Fame: Miami Shareholders Mark D. Bloom, ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are ... Code Talker Award, an essay contest in which patients and their families pay tribute ... presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) ...
Breaking Medicine News(10 mins):