Calif. HIV patient, specialty pharmacy case against Anthem Blue Cross settled

NEW YORK — Anthem Blue Cross patients with HIV can continue receiving their drugs through community specialty pharmacies under a settlement of a lawsuit filed against the healthcare company by an advocacy organization.

In mid-November, Anthem Blue Cross adopted a policy that would require specialty pharmacy patients in California, most of them HIV patients, to receive their drugs via mail order through CuraScript, pharmacy benefit manager Express Scripts' in-house specialty pharmacy, in order to receive coverage.

The policy sparked criticism and allegations that the policy discriminated against HIV patients by forcing them to use mail order, while other members could continue using the pharmacies of their choice. In January 2013, the group Consumer Watchdog and law firm Whatley Kallas filed suit against Anthem Blue Cross. Critics said that HIV patients depend on longstanding relationships with their community pharmacies, which provides services such as medication adherence services, counseling, monitoring and aid in securing financial assistance.

Under the new settlement, Anthem members can opt out of the mail-order program by contacting CuraScript, according to the Law Offices of David Balto, which also represented independent pharmacies affected by the decision.