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