The American College of Allergy, Asthma and Immunology (ACAAI) is concerned that state legislatures and managed care organizations are limiting patient access to physician-recommended allergic asthma and allergy medications.
"Allergists worry that insurance companies, managed care organizations and state Medicaid programs may underestimate the impact on productivity and safety that will occur from non-coverage of new asthma and allergy medications," say Bob Lanier, M.D., president of ACAAI, Fort Worth, Texas.
State Medicaid and managed care programs are increasing the patient's co-payment, restricting access to newer prescription drugs and requiring pre-authorization for their use -- even for asthma episodes requiring emergency care.
In a recent poll of ACAAI members, 73 percent said Medicaid and Medicare patients should have the same emergency drug choices as everyone else, and 46 percent said they will likely take an active stance with insurers to demand relief for their patients.
"Another significant segment of doctors say they will shift their treatment of allergic nasal conditions to topical nasal steroids to save patients out-of-pocket expenses for non-covered antihistamines and keep them from using over-the-counter antihistamines which might make them sleepy. That may mean the cost savings insurance companies plan on may simply be shifted to other prescription medications.
"We are particularly concerned about the effect on children from our poorest families. We think it's problematic to limit the choices in life-threatening disease like asthma," Dr. Lanier said.
The poll also showed many doctors feel they are not in a position to help their patients deal with insurers, or that doctors and patients are caught in the middle.
The ACAAI contends that allergy nasal conditions and allergic asthma are significant medical problems that demand serious attention by patients, employers and insurance companies.
"Asthma and allergy patients who self-diagnose and self-medicate may suffer needlessly by selecting over-the-counter medications on a trial-and-error basis," said William E. Berger, M.D., MBA, president-elect of ACAAI, Mission Viejo, Calif.
"Treatment of allergic asthma and allergic rhinitis without physician evaluation may mask or delay appropriate diagnosis of underlying disorders, such as sinusitis, otitis or asthma. Furthermore, some medications may not effectively control allergy symptoms and others may have undesirable side effects that can vary with dosage, like sedation and impairment.
"The best way to manage allergies and asthma, and lead a life that is as normal and symptom-free as possible, is to see an allergy specialist at the onset of symptoms," Dr. Berger said.
The ACAAI is a professional medical organization comprised of 4,200 qualified allergists-immunologists and related health care professionals. The College is dedicated to the clinical practice of allergy, asthma and immunology through education and research to promote the highest quality of patient care.
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