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Author: JiminyBillyBob Three stars, 500 posts Old School Fool SC1 Red Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 100  
Subject: Blue Cross Blue Shield Michigan Date: 12/27/2012 7:08 PM
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Today, QCOR is down 7% presumably as a result of Blue Cross Blue Shield's (Michigan) policy update on the use of Acthar. From its website are the following instructions:

Coverage will be provided for the treatment of infantile spasms, OR for the diagnostic testing of adrenocortical function only if use of cosyntropin is contraindicated.

Use of H.P. Acthar Gel® is NOT considered medically necessary as treatment of steroid-responsive conditions, unless there are medical contraindications or intolerance to corticosteroids that are not also expected to occur with use of H.P. Acthar Gel®.


This is a neutral update because it falls in line with Questcor management has been saying is the norm for the use of Acthar. Questcor CEO has said more than once that in the case of patients with MS, steroids are given first. There are some that don't respond to steroids, and for these select patients, Acthar is another (maybe only other) viable option.

Acthar is not a first-line treatment -- it is a second line treatment or treatment when nothing else is working. Reimbursement is always on a case-by-case basis, and insurers are notorious for making the physicans jump hurdles if they are prescribing expensive drugs. In the end, as the Questcor CEO has stated, they have had a 90% reimbursement success rate.

It is disconcerting that the stock can drop this much on a neutral update because we can expect more of such updates in the future. However, for the long term investor, these dips can provide attractive entry points.

And you know what Peter Lynch said -- it's poetic that the stocks that provided the best returns for him were the ones that also received the most bumps and bruises along the way.

Carl
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