IDF Resolution Explains Dangers of Arbitrary Insurer Requirements for Previously Diagnosed Patients with Primary Immunodeficiency

Jan 27, 2016, 11:10 ET from Immune Deficiency Foundation

TOWSON, Md., Jan. 27, 2016 /PRNewswire-USNewswire/ -- The Medical Advisory Committee of the Immune Deficiency Foundation (IDF), the national patient organization for persons with primary immunodeficiency diseases, has issued a landmark resolution explaining the danger posed by the arbitrary insurer requirement for a diagnostic vaccine challenge for all previously diagnosed individuals with a specific type of primary immunodeficiency disease, Common Variable Immune Deficiency (CVID). Primary immunodeficiency diseases (PI) are a group of more than 250 rare, chronic disorders in which part of the body's immune system is missing or functions improperly, and CVID is a type of PI in which affected individuals are unable to produce protective levels of antibodies, requiring life-long immunoglobulin (Ig) replacement therapy. Recently, dangerous and unnecessary guidelines regarding this life-saving therapy have been implemented by some insurers, and they are not consistent with the standard of care for people with CVID, causing extreme concern and prompting this critical resolution.

"We are especially troubled by a recent trend among some health insurers to require patients with an established diagnosis of antibody deficiency to present evidence that they have failed to produce antibody after vaccine challenge, even if their diagnosis was established years earlier," the resolution states. "IDF supports this vaccine challenge requirement for newly diagnosed patients with IgG levels greater than 200 mg/dl, but not for individuals already receiving immunoglobulin (Ig) replacement therapy. This is because without this evidence, approval for continued Ig therapy is denied and patients are forced to stop treatment to perform the required assessment that will take several months."

IDF has heard from many individuals with CVID who have been forced to go without their life-saving Ig therapy for five to eight months to meet this vaccine requirement mandated by insurers, risking serious or potentially fatal infection that would normally have been prevented by their Ig therapy.

"This practice of insurers arbitrarily mandating that all established patients carrying a diagnosis of CVID must risk their health and well-being to submit evidence of vaccine non-responsiveness is both unnecessary and unjustified," explains Rebecca H. Buckley, MD, Chair of the IDF Medical Advisory Committee and the J. Buren Sidbury Professor of Pediatrics and Professor of Immunology at Duke University Medical Center. "There are occasionally situations where immunologists may find it advisable to stop Ig replacement to perform a vaccine challenge, but these decisions must be made by qualified medical professionals acting on behalf of their patient's best interests, not insurers." 

To read the complete IDF Medical Advisory Resolution, go to:

About the Immune Deficiency Foundation
The Immune Deficiency Foundation is the national non-profit patient organization dedicated to improving the diagnosis, treatment and quality of life of persons with PI through advocacy, education and research. There are approximately 250,000 people diagnosed with PI in the U.S., and thousands more go undetected. The IDF Medical Advisory Committee is comprised of prominent immunologists from throughout the country to support the mission of the IDF through the development of science based standards for diagnosis and care for individuals with PI.



SOURCE Immune Deficiency Foundation