Blue Cross Blue Shield of Tennessee said its plan to require providers to order specialty drugs from select mail-order pharmacies won't affect patient access to critical drugs, in response to a letter from a group of medical societies criticizing the policy change.
The policy would require physicians to use mail-order pharmacies selected by BCBS to order drugs that have to be administered in-office instead of allowing physician offices to bulk-order the drugs and keep them in-house.
A group of medical societies, led by the American College of Rheumatology, sent a letter Feb. 11 to BCBS, saying the policy would delay patient care, reduce access to much-needed drugs, inflate out-of-pocket costs and increase drug waste.
In response, BCBS said Feb. 13 that the policy change would save Tennessee employers around 20 percent on specialty drugs and that the groups' claims were "stoking fear."
The company said it created the policy in response to requests from Tennessee employers to help manage the cost of specialty drugs, which account for about 1 percent of prescriptions BCBS covers but 50 percent of its total drug costs.
BCBS emphasized that under the new policy, it's still covering the same drugs, administered by the same physicians at the same facilities. It said the 20 percent employers save will go directly to the employers and their members and not BCBS or its pharmacy benefits manager.
"Our solution was to roll out a new way for healthcare providers to order specialty drugs they administer for some of our members — and we stand by it," BCBS wrote.
BCBS said the specialty pharmacies it chose are well-equipped to store, handle and ship the drugs and can deliver them anywhere in the U.S. within 24 hours. The company said that most of the time, specialty drug treatments are scheduled in advance and require prior approval, so the policy shouldn't be a barrier to access.
"But we do understand there are rare cases where a treatment may be prescribed and administered the same day, and we’re working on an exception process to facilitate that," BCBS added.
Read the full news release here.