HIV, AIDS patients upset over Blue Cross' new drug policy

January 23, 2013 9:27:30 PM PST
Anthem Blue Cross has informed some of its members that their medications will now only be available by mail order, and that has some in the HIV/AIDS community really upset.

Many health insurance companies give discounts to members who get their medication through the mail. Now Anthem Blue Cross is going a step further telling some of its members they must receive their prescriptions through the mail if they want them paid for.

One HIV patient we interviewed has just been told by Anthem Blue Cross that from now on he may not buy his medications from a local pharmacy, but instead must get his drugs by mail.

Anthem members with individual and some pooled group policies with HIV/AIDS and other severe medical conditions have been told the same.

"I feel bullied by it or picked out, or excluded from the group," said patient "John Doe".

For privacy reasons he does not want his identity to be known, but he is working with Consumer Watchdog to sue Blue Cross. He says the new rules are discriminatory. The San Francisco based-Courage Campaign believes it is dangerous too.

Their relationship with their pharmacist is critical to their health care, especially here in San Francisco where we have some of the most knowledgeable pharmacists on HIV/AIDS in the whole country," said Eddie Kurtz from Courage Campaign.

Consumer Watchdog's Jerry Flannigan says the change also brings up major concerns about who will see these deliveries being made.

"Blue Cross is being blas? about these privacy concerns from consumers. I can tell you, people are freaked out. The consumers are freaked out over this privacy issue. It's a huge problem," said Flannigan.

The patient we spoke to says he hopes Blue Cross will change its policy. He said, "I hope they see the errors of their way and at least allow me to continue my relationship with my pharmacy."

In a statement, Blue Cross told 7 On Your Side: "Beyond the cost savings and confidentiality? care provided by the specialty pharmacies is associated with patients being more likely to take critical prescription drugs as directed... Anthem's policies do not discriminate on the basis of disease states, and they are reasonable and compliant with applicable laws."

Many insurance companies encourage the use of mail order pharmacies; the difference here is this policy actually demands it. Patients can of course buy drugs from their local pharmacy, but if they do that, the insurance company will not reimburse them; it's coming out of pocket. For the patient we spoke with, that could mean he would end up spending $2,400 a month.

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