Reauthorization by Athem-CA

[Guest guest]

I don't imagine everyone fits the criteria of the question, but I am up for an

annual review if

whether I should be allowed to stay on Xolair. I have been on one year, and my

assumption is

that it is policy for Anthem CA to have the patient re-submit a new prior

authorization every

6-12 months. I remember vaguely a conversation here about someone who improved

clinically on Xolair and was taken off because his/hers numbers went outside the

criteria

range to stay on the drug. Stupid we can all agree, but despite my IgE (before

Xolair 355 and

after 525) still within the criteria, my positive tests for aeroallergens while

on Xolair, my lung

functions have improved enough (>80% for FEV1) to say that I don't require the

drug. Of

course the idiotic logic is that it was supposed to help my lung functions.

However, my

doctor has told me that Anthem might want to see me fail again in order to put

me back on

it. Clearly I know this is all about money, but I feel like a lab rat.

Just for anyone's edification, if lung functions improve because of Xolair,

that should be a

logical outcome and not a reason for removal from the drug. However, if IgE

numbers

plummet AND positive tests for aeroallergens are negative while on Xolair, then

that might

justify a period of time off the drug. I will let you know what happens, but I

have begun to

prepare to have to fight to stay on the drug because I did so well on it. Crazy