Aetna Inc., the third-largest U.S. health insurer, said its coverage policies for immune system disorders treatments from Baxter International Inc. and Grifols SA are unchanged, contrary to an analyst report that said the insurer would favor the Grifols product.
The report released yesterday by Matthew Prior, an analyst for Bank of America Merrill Lynch in Melbourne, said Aetna planed to make Barcelona-based Grifols’s Gamunex the preferred brand of IVIG, an intravenous drug used to boost the immune system. The potential change, which could limit use of Baxter’s rival treatment Gammagard, sent shares of the Deerfield, Illinois-based drugmaker down as much as 5.4 percent.
Aetna isn’t changing its policy, said Cynthia Michener, a spokeswoman for the Hartford, Connecticut-based insurer. More than 90 percent of IVIG used by Aetna members is covered under a medical benefit where there is no distinction between brands, she said. The remaining members have a pharmacy benefit where Grifols’ Gamunex was designated a preferred brand in the fall of 2010 to accommodate some state requirements, though the insurer doesn’t restrict use of other products in the class, she said.
“What the analyst may have seen is a pharmacy clinical policy bulletin covering the IVIG drug class that we posted to the web this month,” Michener said in an e-mailed statement. “While that bulletin is a new post, the policy is not new.”
Highmark Inc. and Coventry Health Care Inc., smaller health insurers, earlier this year made changes to their IVIG coverage that required patients to use a specific product, Prior wrote in his note. A change by Aetna may have signaled more pressure to lower prices in the market, he said.
A telephone call and e-mail to Prior after hours in Australia weren’t immediately returned.
IVIG, also known as intravenous immunoglobulin, is comprised of antibodies extracted from human blood. It is given to patients with immune system disorders who don’t make enough of their own natural defenses to ward off infections.
Baxter rose 1.8 percent to $55.40 at 4 p.m. New York time, after falling 3.1 percent yesterday. The shares have risen 12 percent in the past 12 months.