As Tuesday marks World Asthma Day, one family in Chicago’s suburbs is aiming to bring attention to how an insurance change could impact life-saving care their 12-year-old daughter with severe asthma and food allergies receives.
In addition to asthma, Maddie Krelle can suffer deadly allergic reactions to foods such as peanuts, tree nuts, sesame seeds and coconuts.
She carries an Epi-Pen at all times and relies on a daily inhaler, in addition to receiving the injectable prescription medication, Xolair, at her allergist’s office. Maddie began receiving the Xolair injections in January.
“With Maddie, we are using the injectables to prevent anaphylaxis with food allergy,” said Dr. Priya Bansal, an allergist and immunologist at the Asthma and Allergy Wellness Center in St. Charles.
However, a change to coverage announced by Blue Cross Blue Shield in April updated policies for some medications that are FDA-approved for self-administration, including Xolair.
In a statement to NBC Chicago, the insurance giant said the change “aligns with industry standard and FDA guidelines.”
The statement goes on to say, “in most cases, it is not necessary for these drugs to be regularly administered in the office setting, where additional fees may be charged for the facility cost, professional fee, and the drug.”
Maddie told NBC Chicago she wouldn’t feel safe receiving the shot, which she called “extremely uncomfortable” at home.
“It’s a long shot. It’s like 30 seconds. It really hurts. It’s like gel paste. It goes in there and really hurts,” she said.
However, Dr. Bansal is concerned about future autonomy between doctors and patients.
“In addition, Xolair has a risk of anaphylaxis,” she said. “That’s a discussion between the physician and patient to define what’s going to work the best for them.”
Maddie’s mom said the policy change takes away some certainty with the treatment.
“It’s hard on the parents, but it’s even harder on the children. With insurance taking this away, it’s taking peace of mind from the patient,” Joy Krelle said.
Bansal said Maddie is approved for the treatment for six-to-12 months, though they remain unsure of what will follow.
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