Major Health Insurers Change Policies on Covering Compounded Medicines

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    Major Health Insurers Change Policies on Covering Compounded Medicines


    The following may be old news for some of you. I just thought some may need to know:

    Major Health Insurers Change Policies on Covering Compounded Medicines

    We want to alert you that two of the largest health insurers in the nation — Aetna and BlueCross BlueShield — have changed their policies on covering bioidentical hormones and other compounded medications.

    Aetna will cease coverage of bioidentical hormones and thyroid compounded drugs as of October 1, 2007. After that point, Aetna customers will have to pay out of pocket for the medicines their doctor has determined that they need. To view Aetna’s official policy, please click here to read a section of their newsletter. http://iacprx.convio.net/site/DocSer...e9azhku5.app1a


    In May, BlueCross BlueShield changed its reimbursement policy for compounded medications, calling drug compounding “experimental, investigational and unproven.” This action is based upon the results of an unscientific 2001 FDA study that even the FDA does not support. Click here to view BCBS’s official policy.*BCBSIL/Provider Medical Policies on Fyiblue

    BCBS’s and Aetna’s new policies do not serve patients’ interests, but those of pharmaceutical giants like Wyeth that manufacture equine hormone drug products. Wyeth has a long history of trying to restrict patient choice and interfere in the doctor-patient relationship by trying to limit access to compounded medicines that compete with their products. This action appears to be yet another example.

    If you are an Aetna or BlueCross BlueShield customer, please contact your employer’s HR department and ask them to petition your health insurance company to reinstate coverage of bioidentical hormones and other compounded medicines. Remind them that healthy employees are productive employees and your health depends on these drugs. Your doctor has decided that compounded medicines such as bioidenticals are the best treatment option for you. Both your employer and your insurer have a responsibility to provide you with the medicines you need at a reasonable cost.

    * You must agree to the disclaimer before you may view the BCBS policy.

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    Take steps to protect your ability to obtain compounded prescriptions. Customize the form letter they offer. Doing so will add more weight to your request. Get anyone you know to do the same. Recent events have demonstrated that lawmakers can listen to their constituents.

    Go to the following link and write your lawmakers:


    http://www.iacprx.org/site/PageServe...1secKennedyLeg
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    Quote Originally Posted by nuker View Post
    The following may be old news for some of you. I just thought some may need to know:

    Major Health Insurers Change Policies on Covering Compounded Medicines

    We want to alert you that two of the largest health insurers in the nation — Aetna and BlueCross BlueShield — have changed their policies on covering bioidentical hormones and other compounded medications.

    Aetna will cease coverage of bioidentical hormones and thyroid compounded drugs as of October 1, 2007. After that point, Aetna customers will have to pay out of pocket for the medicines their doctor has determined that they need. To view Aetna’s official policy, please click here to read a section of their newsletter. http://iacprx.convio.net/site/DocSer...e9azhku5.app1a


    In May, BlueCross BlueShield changed its reimbursement policy for compounded medications, calling drug compounding “experimental, investigational and unproven.” This action is based upon the results of an unscientific 2001 FDA study that even the FDA does not support. Click here to view BCBS’s official policy.*BCBSIL/Provider Medical Policies on Fyiblue

    BCBS’s and Aetna’s new policies do not serve patients’ interests, but those of pharmaceutical giants like Wyeth that manufacture equine hormone drug products. Wyeth has a long history of trying to restrict patient choice and interfere in the doctor-patient relationship by trying to limit access to compounded medicines that compete with their products. This action appears to be yet another example.

    If you are an Aetna or BlueCross BlueShield customer, please contact your employer’s HR department and ask them to petition your health insurance company to reinstate coverage of bioidentical hormones and other compounded medicines. Remind them that healthy employees are productive employees and your health depends on these drugs. Your doctor has decided that compounded medicines such as bioidenticals are the best treatment option for you. Both your employer and your insurer have a responsibility to provide you with the medicines you need at a reasonable cost.

    * You must agree to the disclaimer before you may view the BCBS policy.
    Shippens paitences won't be liking that one bit most of the stuff he recommends are compounded in the first place. Like i said nothing that a bottle of test and some good old hcg and some armidex will not fix when properly identified through lab testing
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    It may not seem like it, but I think in the long run we are better off if ins companies don't pay for compounds at all. Most compounders don't bill for them anymore anyway, but some companies will pay on claim forms. But, if they don't pay anything then they don't have any info on what you are taking and can't hold that against you in the future. Also, if they aren't paying for it then they have no interest in trying to help FDA/Phrma regulate compounding. Truth be told, with the way copays have gone most people don't get much back from them anyway.
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    So what is the deal with Senator Kennedy? Is he for compounded drugs or against? I know he was trying to get DHEA banned several months back because he has a friend that has some sort of DHEA equivalent patent.
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    Kennedy is one of the primary leaders for bills regulating compounds. He is not our friend.
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    RPHMark makes a good point here. My copay is about what the cash price is and I don't have to worry about days supply, insurance company hassles, etc.



    Quote Originally Posted by RPHMark View Post
    It may not seem like it, but I think in the long run we are better off if ins companies don't pay for compounds at all. Most compounders don't bill for them anymore anyway, but some companies will pay on claim forms. But, if they don't pay anything then they don't have any info on what you are taking and can't hold that against you in the future. Also, if they aren't paying for it then they have no interest in trying to help FDA/Phrma regulate compounding. Truth be told, with the way copays have gone most people don't get much back from them anyway.
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    Quote Originally Posted by RPHMark View Post
    Kennedy is one of the primary leaders for bills regulating compounds. He is not our friend.
    That is what I assumed based on my past experience and my personal opinion, but I could not deduce from the web form which side he was on.
  

  
 

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