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
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