I HATE MY INSURANCE. They said they would only approve me for Enbrel or Remicade. Must be cheaper. I don't know what to decide. I have to decide by tomorrow at 10 am. Remicade versus Enbrel anyone ?
I haven't used Remicade but I believe you'd have to go to the doc's to get an IV to get the medication whereas with enbrel you give yourself the shots.
I've had great luck with enbrel. I give it two big thumbs up.
Really Kayobe. What do you take with it? My rd says I should not take mtx anymore. I don't want to take Arava. I am going to do more research on it. Guess I better get psyched up to 'STICK IT TO ME" !!!! All of your feedback will be appreciated. My rd is pushing Remicade but I don't want to hang out at the rd office. I am sure he gets more money for it. It is just a business, nothing to do with compassionGood luck, sorry to hear about humira... didnt know there was that much difference...
Oh no! That's a real bummer. I thought that humira was cheaper. Remicade is most expensive. I decided agains remicade cuz they told me I had to go in for a couple hours and get an IV. I think that all 3 are pretty good drugs for RA tho.I am a very strong advocate for Remicade Roxy. Hanging out in the docs office for an hour and a half was great because we were in a room with other patients getting their infusions and you can learn a lot from other people in the same boat as you as you well know. If the initial dosage of Remicade is not working or working well, it can be increased. Having the infusion and then not having to worry about it again for 6-8 weeks worked for me, maybe you don't have the time to take off of work. Before I started taking the Remicade, I was in the pain that you are probably in now where everything hurt. I took the Rem for 3 yrs. and finally had to get off for insurance purposes and have been off for almost 2 yrs. I have never gone back to feeling as bad as I did before the Remicade. Just wanted to let you know Roxy, that it worked wonders for me. If you should decide Remicade, I hope it works as well for you!
No, I'm not a Remicade salesman, but you'd think so, huh?
Allen
Uni, I told rd nurse this morning how I felt and she said the rd said not to take it tonight. I am going to see him tomorrow. I will be reading about Enbrel. I have to do the injections myself. Brett is out of town too much. He is gone now. I still don't like the idea of hanging out at rd office. I will be reading about it. Do you know off hand of significant side effects I should be concerned about? Are you on mtx along with Enbrel? Ok off to research. I have always been through this once and had my heart set on Humira. This link may help you someRoxy--
I've posted this matrix before, but look again. MTX is required to be taken in conjunction with Remicade, whereas it is suggested but not required with the other three biologics. I'm surprised your RD wants you to take Remicade, but not MTX. Don't know about you, but I'm confused by this contradiction...
Table 1: Comparison of Biologic Drugs in RA
|
|
Adalimumab |
Anakinra |
Etanercept |
Infliximab |
|
Inhibits what? |
TNF |
IL-1 |
TNF |
TNF |
|
Type of biologic |
Antibody |
Receptor antagonist |
Receptor |
Antibody |
|
Drug Half-Life* |
12-14 days |
6 hours |
5 days |
9 days |
|
How given |
Subcutaneous injection |
Subcutaneous injection |
Subcutaneous injection |
Intravenous infusion |
|
Given how often |
Every other week |
Daily |
Every week or twice weekly |
Every 8 weeks |
|
Onset of benefit + |
2 -4 weeks |
4-6 weeks |
2-4 weeks |
2-4 weeks |
|
Methotrexate needed? $ |
Suggested, not required |
No |
No |
Yes |
Table 2: Biologic Drugs in RA: What are the side effects, doses, monitoring (testing) and costs?
|
Drug |
Common Adverse Effects |
Rare/Serious Toxicities |
Safety Monitoring |
Usual Dosing Regimens |
Annual Cost* |
|
Adalimumab (Humira ® ) |
Injection site reactions, upper respiratory infections (colds, sinusitis, bronchitis, etc) |
Bacterial infection (e.g., pneumonia or joint infection), unusual infections (tuberculosis or fungal infections), optic neuritis or multiple sclerosis, nerve disorders, worsening of heart failure |
Initially, blood cell counts (CBC) and skin test for tuberculosis. With continued use: CBC and chemistry tests for liver function every 3-6 months |
Initially: 40 mg given once every two weeks as a self-administered subcutaneous injection. Maintenance: same (40 mg subcutaneous every other week) ** comes in a prefilled syringe |
,522 |
|
Anakinra (Kineret ® ) |
Injection site reactions, headache, upper respiratory infections (colds, sinusitis, bronchitis, etc) |
Pneumonia, skin or joint infections, very low white blood cell counts |
Blood cell counts (CBC) every month x 6 months, then once every 3-6 months |
100 mg given once a day as a self-administered subcutaneous injection. May be used with an automatic injector device (called Simpleject) ** comes in a prefilled syringe |
,800 |
|
Etanercept (Enbrel ® ) |
injection site reactions, upper respiratory infections (colds, sinusitis, bronchitis, etc) |
Bacterial infection (e.g., pneumonia or joint infection), unusual infections (tuberculosis or fungal infections), optic neuritis or multiple sclerosis, nerve disorders, worsening of heart failure |
Initially, blood cell counts (CBC) and skin test for tuberculosis. With continued use: CBC and chemistry tests for liver function every 3-6 months |
Initially: 50 mg given once a week or 25 mg given twice weekly as a self-administered subcutaneous injection. Maintenance: same ** comes in prefilled syringe or can be mixed from power before use.. |
,436 |
|
Infliximab (Remicade ® ) |
Infusion reactions (itching, hives, rash, nausea, headache), upper respiratory infections (colds, sinusitis, bronchitis, etc) |
Anaphylaxis (severe allergic reactions with swelling of lips, difficulty breathing, low blood pressure), Bacterial infection (e.g., pneumonia or joint infection), unusual infections (tuberculosis or fungal infections), optic neuritis or multiple sclerosis, nerve disorders, worsening of heart failure |
Initially, blood cell counts (CBC) and skin test for tuberculosis. With continued use: CBC and chemistry tests for liver function every 3-6 months |
Initially: given in the clinic or doctors office as an intravenous (IV) infusion at a dose of 3-5 mg/kg (according to your body weight) at weeks 0, 2, 6. Maintenance: IV infusions every 4-8 weeks.If needed the dose may be increased to 5-10 mg/. |
,940-,287 |
Roxy... i have yet to experience any side effects.. the only thing i have seen is bad "bruising" at the injection site, and ifigured out what it was... the enbrel was not warmed up enough... I now take it out of the fridge about 15 minutes before the shot, and then i warm it between my hands for about 2-3 minutes right before the shot... no more bruises (the coldness shocks the area around the shot causing the bruise)... um yes i am on MTX as well and was on Pred, 5-10mg, went off pred, then got the stupid knee problem, so im back on 2.5, but thinking om going to go up to 5 again... UG!
I know i need to keep getting bloodwork done, for MTX, plaq and enbrel.. we watch liver enzymes etc, so far so good.. RD told me to go every 2 months instead of every month. (yeah less sticks!)
The only major side effect i know of that scared me was a chance of lymphoma... and ithink all of them have that chance... not to worry, when i read the packet (i could send you my insert) it was a SMALL chance...
Hope this helps... I am TERRIFIED of needles, and i succeeded in giving myself the very first shot with a visiting nurse here at my house... ask for a nurse the first time, ot go to the office for a walk thru!!!!!!!!
I read all the literature that my rheumy gave me and when the decision is to be made, I plan on asking for Embrel. I hope you get something!
sara, that's the chart I saw before and was trying to find it on costs..thanks! I'll have to email it to myselfYou're welcome, Murphette. Here's a link to it. You'll find it at the bottome of the narrative.
http://www.rheumatology.org/public/factsheets/biologics.asp? aud=pat
OK YOU GUYS. Thanks for refreshing my memory. I have been reading and considering and reading and considering - I think it will come down to if there is a difference in the cost of what I have to pay and how long I will have to be in rd office for Remicade. UGH. I should not be so pessimistic. I don't know why I was so into Humira. But thanks Uni and Allen. You both seem to have loved your biologic. It seems it does not matter. The mtx may also be a factor. I might just flip a coin. I will find everything out tomorrow and let you know. Thanks for your feedback.p.s. If you are running a fever over one degree above normal they will not give you the infusion because that usually indicates you have an active infection.
[QUOTE=roxy]I HATE MY INSURANCE. They said they would only approve me for Enbrel or Remicade. Must be cheaper. I don't know what to decide. I have to decide by tomorrow at 10 am. Remicade versus Enbrel anyone ?
You don't happen to have Medicare or Medicaid do you? I was just accepted into the Medicare Drug Replacement Program and based on my income I only pay for a co-pay. My Rhmy introduced me to a program that helps find you a plan that you qualify for and if you don't qualify for any, they send you the medicine for free ( to your home) until they can find you one. I was able to get one month for free. Let me know if you are interested in this program! If you still want to take Humira. They also cover Remicade and a few other RA meds.
Hi, first time post, but have been reading for some time. My daughter takes Imuran with the Enbrel, and that seems to work pretty well.WOW You guys are so full of wonderful information. Many things to consider before I go see rd tomorrow. OK you Remicade lovers - how about your veins? Isn't it hard on your veins and I remember when I was hospitalized - it is hard to get that IV in. Do they put it in your hand?
Enbrel also sounds good if I can do the injections. My husband travels a lot and I have decided I will have to learn to do them myself. The other thing I am going to consider is co-pays. Cost of Remicade vs. Embrel - one may cost more than the other.
I so had my heart set on Humira. Watched the video, read about it, and I have heard so many good results on here about it. You guys, as usual, have made me feel better. I just need RESULTS. Probably any biologic will work. So sick of being sick. I feel like my joints are getting worse everyday
Lainniegirl, How wonderful of you to offer to help out. There are so many on this board who do not have good insurance or none at all. Why don't you start a new topic and tell them about any programs that might help them with their meds. I am so glad you posted. Please post again and share. I am 49. I don't qualify for medicare.
OK you guys. 10:30 am tomorrow I see my rd. Who knows, maybe get my first injection. I am really going to push for him to keep me on disability until I get results. Give me a break - I am going to climb in and out of that canyon to the swimming holes - I DON'T THINK SO.
I think I am giving up on mtx. Just makes me too sick. Brenna, I am going to look into Imuran. I don't know what I would have done without this board. You guys prove there is still so much love in this crazy world. Thank you.
Roxy I just wanted to say I hope you get the help you need.I know that I have learned alot from this post.
Good luck at the rd.
I use Humira...and you know I love it; but if I had it all to do over again I'd go with Remicade. I hate the shots. After all this time I still can not quite get use to it. I do it because I know how much it helps me, it's just become part of what I have to do...but I don't think I'll ever really get use to it. I've done it myself once, but my husband does it for me cause he knows I hate it. (I know I could if I had to) Like Allen said; with Remicade you do it and forget it...for about 8 weeks I think. I choose Humira out of all my options because I thought doing it myself verses going to the RD's office would be easier for me. Also Humira was every two weeks verses twice a week with Enbrel. Well then I started using Humira weekly; so I really wasn't getting out of much. The cost for me is for a 4 week supply. Actual cost is about 00. If I took Remicade I'd just have to pay a co-pay like I was going to the doctors office. since it's a speciltist. Roxy~everyone that's on these biologics are having fantastic results. Don't be overly upset by the fact that your insurance won't pay for Humira. You've still got several options...and they are all very good ones. These insurance compaines are very strange about what they will and will not pay for. I can't quite figure them out. One last thing...several people mentioned they don't mind going to get the infusions; in fact they like it. I remember Tbird (Where is she by the way... MISS YA) told me that she liked it too. She'd met a friend there and they would set up their appointments at the same time and always meet for lunch before. Sort of like a girls day. SO don't let that stop you.
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