Some providers who infuse specialty drugs say a new policy from Tennessee's largest health insurance company could cause them to end the service, threatening their practice and forcing patients to find a new place to receive their life-changing drug infusions.
Starting Jan. 1, BlueCross BlueShield of Tennessee will stop reimbursing providers for certain specialty drugs typically administered in a doctor's office or hospital setting. These expensive medications are used to treat conditions ranging from autoimmune disorders - such as rheumatoid arthritis, Crohn's disease and ulcerative colitis - to some types of cancer and eye conditions. The change doesn't affect drugs patients inject or take on their own.
Providers will instead be required to obtain those drugs through a specialty pharmacy in BlueCross BlueShield's preferred network. The move is the insurer's attempt to slow the skyrocketing cost of specialty pharmaceuticals, which account for only 1% of prescriptions but almost half of the company's prescription costs, according to company spokesman Roy Vaughn.