Asthma & Allergy Foundation of America
ISSUES MANAGEMENT EXPERTISE
Asthma & Allergy Foundation of America
CHALLENGE
HMO’s Attempt to Exclude Coverage of Prescription Allergy Medications
In the fall of 2002, health plans attempted to stop paying for commonly prescribed allergy medications when Claritin® became available without a prescription. The Asthma & Allergy Foundation of America (AAFA) began speaking out on behalf of patients, recognizing a growing trend by HMOs to drop or reduce coverage of prescription medications. AAFA looked to Perry Communications Group to create a communications strategy that would educate regulators and secure patient protections.
SOLUTION
Make The Issue Hit Home With State Regulators
Perry Communications Group created a campaign to increase awareness that allergic asthma is a significant health problem, which cannot be successfully treated by any one medication. Consumer advocates and physician experts compiled extensive materials – published research, patient experiences – showcasing why an HMO’s request to discontinue coverage of prescription non-sedating antihistamines should be denied. AAFA established its thought leadership at informational briefings with and public hearings held by the Department of Managed Health Care (DMHC). To solidify its case, AAFA launched a patient resource program in allergists’ offices across California to help state regulators quantify the scope of patient problems. Table tents explained existing patient protections and postcards were used to collect patient concerns. Patient stories and advocate viewpoints were literally assembled as a “Message in a Bottle” and delivered en masse at a DMHC public hearing.
RESULT
DMHC Requires HMOs to Retain Coverage
- Approximately 400 patients contacted AAFA with delays in care and health complications.
- On-message media placements surpassed seven million impressions, including a Los Angeles Times article that featured a state regulator acknowledging the significance of allergies as a chronic condition meriting drug coverage.
- Sixteen notable patient organizations were mobilized to weigh in with viewpoints about why the chronically ill need essential medicines and why a “one size fits all” treatment approach is ineffective and ends up costing California more.
- The Department of Managed Health Care issued an advice statement prohibiting health plans from excluding classes of medications simply because one drug option becomes available without a prescription.
