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 genera