Thousands of Massachusetts residents who have health insurance through Harvard Pilgrim Health Care are learning that the company will no longer cover specialty medications known as compounded drugs, because of safety and cost concerns, a decision that has infuriated pharmacists and worried patient advocates.
The action follows last year’s deadly fungal meningitis outbreak linked to a Massachusetts compounding pharmacy.
In a letter to patients, Harvard Pilgrim, the state’s second-largest insurer, said it will end coverage of these medications Aug. 7, but will consider appeals case by case.
“If your physician believes that there are no other available treatment options for you, your physician may submit an exception request on your behalf,” the letter said.
According to the letter, the appeal process would require physicians to send information about the compounded drug that is being sought including its ingredients, other prescription medications that have been tried to treat the patient’s condition, and other details.
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