Humira and Insurance | Arthritis Information

I don't even want to think about this.

RD faxed presciption to CVS. FAIL.

So, I have to get prior authorization, and I would have to get it through a speciality pharmacy. I should have asked him about this at the appointment, I know they monitor these drugs closely.

I am worried because the nurse also gave me this Humira discount card that would pay 100% for 6 months up to 5, then 100% up to 5 for the next 6 months after I pay . (are these available to everyone?) Anyway. Is she assuming I am going to have trouble getting insurance to pay?

So I'm just worried about getting the RD to sign prior authorization, but there's no reason he shouldn't, right?

I am able to work each day, but I guess that's not the insurance company standard. I am RF negative, anti-CCP negative, ANA all fine. CRP was 9.8 last time, ESD was just repeated last week.

I was on 20 oral MTX for six months, then injectible for 3 months, now Arava, although only 2 months. I got a small erosion on my wrist while I was on MTX, and my jaw has erosions. I haven't had a lot else x-rayed but further erosions are part of why I need to do this.

Ugh. I need to summon the energy for this.

Thank you for letting me rant.

KatieG2009-02-08 11:19:46

Hi Katie,

My insurance was the same way. My RD went ahead and got me pre-authorized for enbrel, humira and remicade. She actually left the choice of which one to me. I chose enbrel and it is great. The rd's are used to this process and it is fairly standard. I get my enbrel through Walgreen's even though my mail in service is medco. They are fantastic and really keep up with your care. Heck, they call you to refill your prescription. They have pharmicists on call 24/7. I couldn't ask for a better service. Let me know how you make out. Hiking_gal

edited for spelling. HG

hiking_gal2009-02-08 11:38:33

Thanks!

I'm just wondering why this didn't occur to him at the time, so my ridiculous fear is that he has prescribed it but doesn't think he could get it authorized. Surely not. Maybe just a mental slip on his part, or maybe he does deal with insurance co's that don't require it (?)

FYI, my RD's opinion was that the risk of infection is greater in Remicade than in Humira or Enbrel. And then I think he chose Humira before me, maybe just because it's once every two weeks. He gave me a pen. I was in such a daze during all of this...

What made you choose Enbrel?

I have made a decision that if Humira doesn't work, I'm not trying anything else until we've either had a 3rd baby or decided not too. I feel like I need to leave some ammunition out there in case things take a turn postpartum. It's sad, because I breastfed both my boys forever, but I have almost decided that if we have a third, we will be prepared to have to do bottlefeeding from the get go if I can't do without Mobic, or otherwise. But I think you can take pred, but when I was on that before it wasn't enough alone. Not a high dose though.

Okay now I'm just rambling, sorry, I haven't had time to be on here in forever...

Also HK I found out my T4 of 1.24 was high, with TSH of .05. She wrote me a letter and said you don't need to be on this right now, and my thyroid antibodies were negative again, so she thinks it's some type of thyroiditis other than autoimmune/hashis. Subacute I guess? will have to see if it comes back after levoxyl is out of my system. And also that nodule was still .8 cm. I think it was much more prominent only because my thyroid isn't as swollen now.

Hi Katie,

I chose enbrel because I think it had been out on the market a little longer than humira. But the real reason is I was afraid I'd forget to take my humira seeing as it is two weeks apart. I give myself insulin shots about 6 times a day so I sometimes forget that I have to give myself a shot once a week, let alone once every two weeks. I get really scattered like that. Probably from all the meds they have me on.

Wow, that is some case of thyroiditis. The docs seem to be very cautious and that's a good thing, but, the problem is the patient has to suffer through it. My thyroid nodule has remained .7 cm for about 5 years now but because I have so many swollen lymphnodes (38 total), they monitor it very closely. Hopefully the humira will make you feel better. That, like so many of these drugs takes time. I was fairly lucky because the enbrel made me feel better after my second shot. That was pretty good. I have noticed that my swelling is up but the rd is weaning me off of prednisone so that is why the swelling is there. Good luck with the humira and the thyroid. Keep us posted! Hiking_gal

Thanks! Wow, I can't imagine doing all those shots. I will complain a little less about my Humira every two weeks! I had the MTX shots down, so I'm wondering if I should have asked for syringes, but they didn't hurt like Humria will, so I'm thinking a pen may be best anyway...
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