Blue Cross Blue Shield to require at-home injections for some asthma medications

Blue Cross Blue Shield (BCBS), under its parent company Health Care Service Corporation, is changing how certain asthma injections are administered.

Effective April 15, 2025, some patients will need to self-administer asthma medications at home rather than receiving them at a clinic. The affected medications include Fasenra, Tezspire, Nucala, and Xolair.

BCBS will update coverage criteria to decide whether these medications should be administered in a clinic or at home, based on medical necessity.

Concerns from doctors:

1. Dr. Maya Gharfeh, an allergy physician, says asthma affects about one in 10 Oklahomans and is worried about allergic reactions (e.g., anaphylaxis), which are easier to manage in a healthcare setting.
2. She is also concerned that patients may be less likely to take their medication regularly if they are responsible for self-administering it at home.
3. Dr. Gharfeh believes the decision to have the medicine injected at a clinic by a healthcare professional or at home by the patient should be made between the patient and the provider.

Blue Cross Blue Shield statement:

"BCBSOK is committed to expanding access to quality health care. We are updating medical policies for some medications that are FDA-approved for self-administration. Effective April 15, 2025, if not medically necessary to be administered in a health care setting under a member’s medical benefit, the drugs may be processed under a member’s pharmacy benefit for self-administration."

1. Blue Cross Blue Shield said it will notify impacted members currently being treated with those medicines under the medical benefit and administered in a healthcare setting.
2. Medicare and Medicaid will not be affected by these changes.
3. For more information, BCBS members can contact customer service or log onto Blue Access for Members.