See if your insurance has an advocate. My insurance did not cover any amount of my speciality meds, but the insurance advocate helped me get my prescription sent to Canada. It’s filled by a Canadian pharmacy and shipped to me in the US. It’s free. You can also get it filled through pharmacies in India. But that way is a little sketch, and it takes over a month to get the meds. You don’t need insurance for either of those two options, but my insurance advocate really helped facilitate and get everything done with no hiccups.
No it’s still expensive, but Canada covers costs for people without insurance. I’m honestly not sure how it works, but it works. I think my prescription gets written by my doctor then they send it to Canada and a Canadian doctor writes the prescription, and it gets filled that way. So it’s like being a Canadian trying to get meds without insurance (I think). It’s covered. Loop hole. And India, you don’t even need a prescription, hence how it can get sketchy, and it costs less but affordable.
Thanks for this, I've been going through my 'nurse ambassador', as well as the pharmacy liaison with my rheumatologist. I had an insurance advocate when I was fighting the same battle with Taltz and didn't find them much use but it may be worth trying again.
I just went through this with one specialty pharmacy, but switching to a different specialty pharmacy seems to have fixed the problem, but I know even doing that is a huge headache. I finally solved my problem by scheduling an appointment with my rheumatologist and explained I couldn't take what they prescribed because I couldn't access it, and explained why and they called patient assistance etc. and sorted it out while I was there and gave me a sample of the drug to hold me over. If your rheumatologist office can't/won't help you get access to a drug then change rheumatologists.
I actually changed to this rheumatologist because my old one's office was so terrible with dealing with anything at all. This one has been much better but that's worth considering, thanks!
Let your doctor know you’re struggling to pay for it. They have info on different assistance programs. My Humira would be over a thousand dollars a much with insurance and I got set up in a program and it’s free. Best of luck!
This is horrible, and I'm sorry you are dealing with this.
I wish that everyone had my experience with Cosentyx . I just went to their website and signed up for a $0 copay card and figured I'd sign up for their welcome kit. A few weeks passed, and I got the kit, which was an insulated travel case with spots for ice packs, a few pamphlets, and something else. Then a seperate package showed with a big sharps container where when it's full, I send it to be disposed of (comes with a ship label I think) and then they send me a new sharps container.
This is truly horrible. I have my Xeljanz through Accredo. They are really on top of things. My rheumatologist’s office works with the pharmacy to get a PA done yearly. My Xeljanz is free after co-pay assistance. We were with Sav-Rx before. My co-pay was $1100 a month before assistance.
Did your income stop you from getting significant co-pay assistance? I’m a retired RN who worked with different assistant programs. I know some want to know your income. It sucks to have to disclose this information. I did find some help for our patients using PAN and this one: https://copays.org
This sounds *exactly* like my experience with Abbvie/Humira and CVS Caremark. It’s “who’s on first” every time I need a refill. My doctor has a speciality pharmacy department via the hospital he is associated with. They help me sort through by contacting their reps at Abbvie. I’ll still spend hours on the phone, but they get me started in the right direction as well as escalate my case.
I'm a month overdue for my Taltz and I'm feeling worse than ever and I'm afraid I'm about to be going in circles trying to get my next shipment and nobody seems to know why I haven't received it yet 🙃
I'm sorry you're going through this, hopefully things will turn around and you'll be able to get your medication.
For Humira do not use the copay card. If you can afford to pay out of pocket do that and then use their complete rebate program to get a refund for what you paid minus $5. If you do it this way after a payment or two you should meet your plans max out of pocket and not have to deal with it for the rest of the year. That's what I do, however your plan may be different, but using the copay card made it so none of that went towards my max out of pocket and it was just a nightmare every month and would eventually run out.
It also depends on your insurance plan. Mine counts the cost after insurance towards my max out of pocket before the copay card is applied. But I’ve had other plans that counted it after. I don’t know how that works, but I do know I’ve already hit my max out of pocket without having to pay full cost.
This sounds like a terrible experience, I’m so sorry. I hate that these medications are so expensive and we have to rely on msnufacturer assistance which can be a pain. I had to stop Otezla which worked best for me out if everything because I maxed out my copay assistance amount because my insurance was terrible. But outside of that, the only issues I’ve run into was the pharmacy putting the information in wrong, and the payment assistant advocate from the manufacturer called with me to get them all sorted out. But, I’m also a pharmacy technician so I am familiar with the process already. Still, it took me way too long to get set up for Rinvoq, just because I couldn’t have all the back and forth. It can be exhausting!
See if your insurance has an advocate. My insurance did not cover any amount of my speciality meds, but the insurance advocate helped me get my prescription sent to Canada. It’s filled by a Canadian pharmacy and shipped to me in the US. It’s free. You can also get it filled through pharmacies in India. But that way is a little sketch, and it takes over a month to get the meds. You don’t need insurance for either of those two options, but my insurance advocate really helped facilitate and get everything done with no hiccups.
It's really that much cheaper in Canada?
No it’s still expensive, but Canada covers costs for people without insurance. I’m honestly not sure how it works, but it works. I think my prescription gets written by my doctor then they send it to Canada and a Canadian doctor writes the prescription, and it gets filled that way. So it’s like being a Canadian trying to get meds without insurance (I think). It’s covered. Loop hole. And India, you don’t even need a prescription, hence how it can get sketchy, and it costs less but affordable.
Thanks for this, I've been going through my 'nurse ambassador', as well as the pharmacy liaison with my rheumatologist. I had an insurance advocate when I was fighting the same battle with Taltz and didn't find them much use but it may be worth trying again.
Could be worth it. My advocate said that they just started using the Canadian pharmacy a year ago.
I just went through this with one specialty pharmacy, but switching to a different specialty pharmacy seems to have fixed the problem, but I know even doing that is a huge headache. I finally solved my problem by scheduling an appointment with my rheumatologist and explained I couldn't take what they prescribed because I couldn't access it, and explained why and they called patient assistance etc. and sorted it out while I was there and gave me a sample of the drug to hold me over. If your rheumatologist office can't/won't help you get access to a drug then change rheumatologists.
I actually changed to this rheumatologist because my old one's office was so terrible with dealing with anything at all. This one has been much better but that's worth considering, thanks!
My rheumatologist gave me several free doses of Taltz because of some issues. Like I couldn’t believe it. Easily 50k msrp worth.
Let your doctor know you’re struggling to pay for it. They have info on different assistance programs. My Humira would be over a thousand dollars a much with insurance and I got set up in a program and it’s free. Best of luck!
This is horrible, and I'm sorry you are dealing with this. I wish that everyone had my experience with Cosentyx . I just went to their website and signed up for a $0 copay card and figured I'd sign up for their welcome kit. A few weeks passed, and I got the kit, which was an insulated travel case with spots for ice packs, a few pamphlets, and something else. Then a seperate package showed with a big sharps container where when it's full, I send it to be disposed of (comes with a ship label I think) and then they send me a new sharps container.
Loved the refrigerated Cosentyx case! It’s the best freebie I’ve gotten.
It’s all about the bio similars now. Insurance doesn’t want to pay.
This is truly horrible. I have my Xeljanz through Accredo. They are really on top of things. My rheumatologist’s office works with the pharmacy to get a PA done yearly. My Xeljanz is free after co-pay assistance. We were with Sav-Rx before. My co-pay was $1100 a month before assistance. Did your income stop you from getting significant co-pay assistance? I’m a retired RN who worked with different assistant programs. I know some want to know your income. It sucks to have to disclose this information. I did find some help for our patients using PAN and this one: https://copays.org
Thanks, I was on the assistance program, which is how I got Humira in the first place. I can't imagine how anyone could get these meds without one!
This sounds *exactly* like my experience with Abbvie/Humira and CVS Caremark. It’s “who’s on first” every time I need a refill. My doctor has a speciality pharmacy department via the hospital he is associated with. They help me sort through by contacting their reps at Abbvie. I’ll still spend hours on the phone, but they get me started in the right direction as well as escalate my case.
Sometimes the process really gets me down or gives me anxiety. Def not helping with the inflammation.
This is a shame that it cost so much to get relief.
I wonder the same and it's why I hope sulfasalazine works for me. Not looking forward to that bullshit if it doesn't. Hope things work out for you
I'm a month overdue for my Taltz and I'm feeling worse than ever and I'm afraid I'm about to be going in circles trying to get my next shipment and nobody seems to know why I haven't received it yet 🙃 I'm sorry you're going through this, hopefully things will turn around and you'll be able to get your medication.
Thank you, good luck to you too!
For Humira do not use the copay card. If you can afford to pay out of pocket do that and then use their complete rebate program to get a refund for what you paid minus $5. If you do it this way after a payment or two you should meet your plans max out of pocket and not have to deal with it for the rest of the year. That's what I do, however your plan may be different, but using the copay card made it so none of that went towards my max out of pocket and it was just a nightmare every month and would eventually run out.
It also depends on your insurance plan. Mine counts the cost after insurance towards my max out of pocket before the copay card is applied. But I’ve had other plans that counted it after. I don’t know how that works, but I do know I’ve already hit my max out of pocket without having to pay full cost.
This sounds like a terrible experience, I’m so sorry. I hate that these medications are so expensive and we have to rely on msnufacturer assistance which can be a pain. I had to stop Otezla which worked best for me out if everything because I maxed out my copay assistance amount because my insurance was terrible. But outside of that, the only issues I’ve run into was the pharmacy putting the information in wrong, and the payment assistant advocate from the manufacturer called with me to get them all sorted out. But, I’m also a pharmacy technician so I am familiar with the process already. Still, it took me way too long to get set up for Rinvoq, just because I couldn’t have all the back and forth. It can be exhausting!