Harvard Pilgrim Health Care Will No Longer Cover Compounded Drugs

BOSTON (CBS) – Harvard Pilgrim Health Care is notifying customers that it will no longer cover compounded drugs due to costs and safety concerns.

The decision comes in the wake of last year’s deadly meningitis outbreak that began at a compounding pharmacy in Framingham. New England Compounding Center was shut down after producing thousands of vials of a steroid pain medication that caused fungal meningitis. Dozens of people died and more than 700 others were sickened.

Todd Brown, Executive Director at the Massachusetts Independent Pharmacists Association is not buying what the insurance company is saying.

“I don’t think the safety concerns are really real,” Brown told WBZ NewsRadio 1030. “I think it’s a thinly veiled attempt to justify their decrease in coverage.”

Harvard Pilgrim says it will stop the coverage on August 7th, but will still allow patients to appeal. Decisions will be made on a case-by-case basis and the burden will be on doctors to argue for use of the drugs.

“We’re very concerned that patients will not have access to these medications,” Brown says. “There are lots of instances where the only possible treatment is compounded medication.”

Harvard Pilgrim has not responded to WBZ’s request for a comment.

According to The Boston Globe, Blue Cross Blue Shield of Massachusetts and Tufts Health Plan will continue to cover compounded medications.


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