HARRISBURG, Pa., March 21, 2011 /PRNewswire/ — Beginning April
1, Highmark Blue Cross Blue Shield (Highmark) will force a number
of their insured patients with primary immunodeficiency diseases
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 being treated successfully 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 become ill and suffer possible life-threatening
reactions before Highmark will even consider covering another IgG
product for that patient.
“Immediately after our public protest last week of this
unconscionable intrusion into the patient and physician
relationship, Highmark responded with some proposed modifications,”
stated Dr. Michael Blaese, Consulting Medical Director of the
Immune Deficiency Foundation (IDF). “But they still fail to address
the fundamental issue at hand – instead of doctors who are
experienced in treating primary immunodeficiency diseases, Highmark
will be making the determination about which IgG therapy will be
the most appropriate for patients.”
IgG therapy is a biological treatment that, unlike most
prescription drugs, is not generic or interchangeable. While all
IgG products are FDA approved therapies for patients with primary
immunodeficiency diseases, the FDA recognizes each as a unique
therapy as a result of the manufacturing processes, stabilizers
used, and other factors that make each product different. In
fact, patients can experience a wide range of adverse reactions to
one IgG product while tolerating others without problems. 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 reacti
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