Blue Shield Of California Decision Was 'Inevitable', Sharon Health Care Expert Says

Blue Shield of California has stopped covering a drug used to treat metastatic breast cancer, and Sharon resident isn't surprised.

The latest monthly Drug Topics magazine quotes Vogenberg, principal at the Institute for Integrated Healthcare, in a story about Blue Shield's decision to stop covering bevacizumab for this treatment. The magazine bases its story on a New York Times report.

Vogenberg told Drug Topics that "it was inevitable that coverage declines would occur, given the economic recession and intermediaries looking for ways to generate savings in benefits for their clients."

"When an opportunity in a key cost category such as breast cancer occurs, it will be more likely that intermediary payers as well as CMS [Centers for Medicare & Medicaid Services] will seek to avoid or restrict reimbursement.

"Once reimbursement change such as this occurs, more restrictions can follow, in less obvious areas of medication or medical care."

Sharon Patch on March 20.