For This Insurer, Breathing Now Comes With A Catch

[Passages]

Blue Cross Blue Shield just made it harder for many patients to get vital asthma and allergy medications — all while channeling more profits toward a PBM-affiliated pharmacy.

Health Care Apr 25, 2025

Madison, a 12-year-old from Illinois, visits a medical clinic every other week to get injections of Xolair, a powerful asthma and allergy medication. The drug helps protect her from severe asthma attacks as well as serious allergic reactions to peanuts, tree nuts, and sesame seeds. Medical professionals at the clinic monitor her response to the injections, since the drug can trigger life-threatening anaphylactic shock.

But now, thanks to a policy change by her insurer, Blue Cross Blue Shield, Madison may have to self-administer the expensive injections at home.

Without access to in-clinic injections, “I don’t think I would want to do the shot at all,” Madison said. “I don’t know if I would be comfortable even doing it.”

Blue Cross Blue Shield, one of the country’s largest health insurers, just made it much more difficult for patients like Madison to get potentially lifesaving medications. The move will force many patients to self-inject at home, cutting costs for the insurance giant and, experts say, channeling more profits toward a single specialty pharmacy contracted with the insurer.

https://www.levernews.com/for-this-insurer-breathing-now-comes-with-a-catch/