Anthem Blue Cross suspends mail-order policy for chronic disease patients



In November, specialty pharmacy patients in California covered by Anthem Blue Cross were notified that come Jan. 1 they would be required to fill their prescriptions through CuraScript, a mail-order pharmacy based in Florida and owned by Express Scripts. Otherwise, patients would have to pay full price for their costly medications at their local pharmacy. Today, Anthem announced it has suspended the policy indefinitely.

The policy would have affected mostly HIV/AIDS patients but also those with cancer, multiple sclerosis, and osteoporosis as well as the pharmacies that provide services to these patients.

The non-profit organization Consumer Watchdog and law firm Whatley Kallas filed a class-action lawsuit against Anthem in January. The resulting decision marks the first time that consumers and pharmacies have been able to force an insurance company or pharmacy benefit manager to suspend a mandatory mail-order policy, according to the Law Offices of David Balto, which also advocated on behalf of the pharmacies affected by Anthem’s policy.

“Anthem's actions would have harmed thousands of vulnerable HIV/AIDS patients, preventing them from receiving the first-rate health care they need and deserve,” David Balto said. “Study after study has demonstrated that pharmacies that specialize in serving HIV/AIDS patients deliver better service, improve health care and lower health care costs. This is a landmark achievement in consumers’ and pharmacies’ ongoing battle against restrictive health care networks. Anthem's decision to suspend their policy preserves patient choice and will lead to better health care results.”

Anthem had previously said it was going to switch to home delivery to buy drugs in bulk, cut costs, and increase patient adherence. It would also offer patients a 24-hour access line to social workers, nursing assistance, and pharmacists through CuraScript.


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