Hartford Business Journal

HARTFORDBUSINESS.COM | JULY 28, 2025 11 Patients treated at infusion centers have a variety of "complex and chronic conditions," he said. "Think rheumatoid arthritis, Crohn's disease, MS, severe asthma, a number of chronic and complex conditions. Many of these patients, unfortunately, are living with these conditions for the rest of their life." Patients receive regularly sched- uled treatments, and the infusion process takes time. As an example, Warren cited the MS drug Ocrevus, for which the treatment can last three to five hours, he said. Infusion centers provide patients a way to receive treatment in a convenient location that allows them to maintain "their dignity and their privacy," and their quality of life, Warren said. For Aetna/CVS Health patients, the recent change threatens to disrupt their treatment, he said, because many infusion centers and hospitals refuse to accept white bagging mandates. "So, you're creating a patient access challenge, especially in rural areas, where a location can no longer accept patients because of this white bag mandate," he said. Process 'inflexibility' Woody Baum, CEO of Local Infu- sion — which has 31 infusion centers in eight states, including four in Connecticut — says the white bag mandate creates additional risks for patients. The buy-and-bill model is "logisti- cally a lot easier for the patient," he said, because there is no middle man involved in securing the medication. "A lot of these specialty pharma- cies, in part because they're payer mandated, they don't have great customer service," Baum said. "There's often a lot of delivery issues, logistical issues. … So, when you intro- duce a third party into that process, it just often leads to delays in care." In addition, he said, if a patient decides to seek treatment elsewhere because of a delayed drug ship- ment, his centers are not allowed to use the white bag medication on someone else. "It just adds a lot of inflexibility to the process, and that's a lot of waste and financial risk to the system as well," Baum said. Kathleen Holt, the state healthcare advocate, says there are other risks as well. White bagging damages the integrity of the supply chain, she said, "because you can't trace and verify where these drugs are coming from in a way that you can when you have more control over them." She also noted that a patient's condition can change between the time a drug is ordered and the time it arrives. With buy and bill, a doctor can adjust using medications in his inventory. With white bagging, the medication is no longer suitable when it arrives, delaying care. "It all goes back to this fragmented, rather selfish way of insurers choosing their own processes over the safety and other protocols that providers have put in place," Holt said. In his emailed response to questions about this, Blando said Aetna/CVS Health has "more than 50 specialty pharmacies" in Connecticut, including almost 40 "non-affiliated specialty pharmacies" that can be used to fill prescriptions for the five drugs. "These specialty pharmacies have the experience and capability to deliver drugs in a timely and reliable manner to promote ease of access for members and providers," Blando states. "They will work with providers and members to ship medications according to 'needs by' date for patient appointments." He added that each of the five drugs "has at least one alternative available as a medical benefit, so providers have the option of prescribing a drug that could be purchased from them." Warren, of the IPA, said 10 states have passed laws either limiting or banning white bagging mandates. Sen. Matt Lesser (D-Middletown), a member of the state Prescription Drug Task Force, said he agrees that the General Assembly and the task force should address the issue in the future. He noted lawmakers did pass legislation during the 2025 session to address prescription drug prices, but it did not address white bagging. "The bipartisan drug task force has been really successful this year, and I think we are going to keep going," he said. "We have a lot of additional problems to address." WHAT'S IN THE BAG? Definitions for white, brown, clear and gold bagging, as presented by the Academy of Managed Care Pharmacy: • White bagging: Patient-specific medications delivered from a specialty pharmacy, either owned by or contracted by a patient's insurance company, to the healthcare provider. • Brown bagging: Patients pick up prescribed drugs at a specialty phar- macy, or have them delivered, then bring them to their provider. • Clear bagging: A healthcare system's internal specialty pharmacy dispenses a drug and delivers it to the provider. • Gold bagging: A health system uses its in-house specialty pharmacy and oversees the entire process, including prescribing, dispensing and administering the drug. www.borghesibuilding.com 2155 East Main Street Torrington, Connecticut 06790 860.482.7613 Check out our new website! Building Ideas That Work... Building Ideas That Work... © 2011 BlueScope Buildings North America, Inc. All rights reserved. Butler Manufacturing ™ is a division of BlueScope Buildings North America, Inc. Towns have relied on Borghesi Building & Engineering Co., Inc. for help to marry the budget with design and technology. e result is an efficient, practical building that "works". PUBLIC WORKS | WATERFORD HIGHWAY GARAGE | BARKHAMSTED TOWN GARAGE | HARWINTON

• Cover