HMO’s Greed Hurts Allergy Sufferers

Arlington, VA —- Managed care organizations are conducting an orchestrated campaign to discriminate against allergy sufferers — largely in an effort to increase their own bottom line, according to the 60 Plus Association.

Media reports have indicated that Humana and UnitedHealth, two of the nation’s largest health insurers, are actively considering dropping an existing drug benefit for their members by stopping coverage of the latest prescription-only non-sedating antihistamines (NSAs), in the event that one or more NSAs are switched to over-the-counter status in coming months. They are also considering egregiously raising co-payments by beneficiaries.

This new HMO policy is a clever strategy for reducing their drug expenditures by shifting costs to their enrollees without having to formally change their benefit structures or co-payments,” said Jim Martin, President of 60 Plus Association. “Allergy treatment is not all economics. By removing a class of drugs completely from the formulary, HMO’s may place an entire form of treatment beyond the reach of patients, at the same time severing patient ties with their physicians on significant treatment matters. This is deplorable and driven by nothing but old-fashioned greed.”

* Classic antihistamine side effects such as sedation can lead to twice the normal risk of a serious injury, according to a study published in the Annals of Allergy, Asthma & Immunology (2002; 89:244-250.)

* A 1999 study estimated that 3.4 million workdays are lost every year to allergies. Lost wages accounted for more than $150 million dollars a year, according to the study, published in the American Journal of Managed Care. Allergies affect 40 million Americans every year.

* A recent survey conducted by the American College of Allergy, Asthma & Immunology (ACAAI) detailed how 94 percent of allergy sufferers said their quality of life, often including work productivity and concentration, is affected when their allergy symptoms act up. (Nationwide telephone survey conducted by RoperASW, August 5 to August 14, 2002, among 300 adults, aged 18-64, who suffer from allergies. Source: American College of Allergy, Asthma & Immunology.)

“What is the allergy sufferer supposed to do when their HMO abandons them?” asked Martin. “I’ll tell you what they’ll do — they’ll either pay the additional out-of-pocket costs for their medicines or be forced to choose to go without the drugs entirely. If they’re subsequently then forced to choose a sedating antihistamine, you’re opening the door to potentially egregious workplace safety issues, to say nothing of lost productivity.”

“Bottom line: HMO’s are rationing health care to line their own pockets,” said Martin. “They have proven time and again they don’t care one whit about consumers; on top of their neglect of allergy sufferers, which constitute a significant sector of the health population, they’re jacking their premiums up left and right. And the money machine keeps on rolling. Consumers need to wake up and smell the hustle.”