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Humira and Medicare

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Rheumatoid Arthritis
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Posted 9/26/2013 6:28 PM (GMT 0)
I have been on Humira for 8 years with good results, I am going on Medicare and am worried about the cost. The drug companies will not help with the payment if you are on a government program, I have been paying $5 a month with insurance and the card from the drug company. I don't want to change to another medication and I think when I get out of thr donut hole it won't be too bad. I would like to hear from others who are on Medicare and Humira. Any information would be appreciated, thank you!
Posted 9/27/2013 11:27 AM (GMT 0)
I'm on Medicare but not on Humira. My rheumatologist has been talking to me about this medication and since my Medicare Part D does not cover Humira he suggested Remicade infusions. He said the medication is about the same and Medicare will cover infusions. You might want to talk to your doctor about this. Hope this helps.

Sherrine
Posted 9/27/2013 2:22 PM (GMT 0)
Thank you for your reply! My doctor has talked to me about changing to Remicade but I hate to change since the Humira has worked so well for me. I am just not sure what to do? I wish someone could tell me exactly what the Humira is going to cost, my insurance said $400 a month, my pharmacy said $800 a month before you get in the donut hole and then it would be $2,600 for a month or so and then 5% of the total cost after that but no one can tell me exactly what that figure will be. Still confused!
Posted 9/27/2013 6:43 PM (GMT 0)
My pharmacy said it was going to be over $2,000 also.  That is out of the question for me.  From what my understanding is, Humira and Remicade are a couple of the new biologic medications and they all work pretty much the same.  You might want to check out Drugs.com for both of them.  That site is quite thorough. 

 

Also, ask your doctor if Remicade is quite similar to Humira and maybe that will ease your mind.  I know that you know how Humira works for you but not Remicade.  But, I had to switch from one medication to a different one that was similar for my diabetes and you know what?  I never noticed a bit of difference!  This could be true of Humira and Remicade.

 

I personally think the Remicade would work for you since your doctor and my doctor have said the same thing.  I'm sorry you have to even think about this.  Medications are just too darn expensive.  Do let us know what you decide to do because we do care about you.

 

Sherrine

Posted 9/27/2013 8:27 PM (GMT 0)
Thank you for your reply, I will let everyone know what I decide. I want to talk to my rheumatologist before I make a decision. Thanks
Posted 11/13/2013 3:44 AM (GMT 0)
Hi, Thanks so much for your interest. I had decided to stay on the Humira and then I ordered it the first time on the Medicare and BC RX plan, it cost me $800, just a little more than the $5 I had been paying! I then received a letter from the insurance stating that they filled it this one time but my doctor would have to prove that I medically could not take the other drugs that they do cover. I suppose I will have to try one of the others (Remicade, Cimzia) and see if they will work without adverse side affects. I have an appointment a week from Monday with my Rheumy so I will see what she recommends. To be continued.....
Posted 11/13/2013 12:10 PM (GMT 0)
When I first went onto Medicare the cost of the Humira was unbelievable.  My rheumy helped me apply for assistance through some company (and I apologize I can't remember the  name).  It did save me some money was still very expensive.  For the past year my rheumy has been able to provide me with samples and I so very grateful to her.  Talk to your doctor to see if they can help.

Best of luck

Alicat

Posted 11/13/2013 12:20 PM (GMT 0)
I tried the Remicade infusions and broke out in a rash so my Dr. said I couldn't take it, Enbrel injections gave me a very bad injection site reaction.   So far Humira is the only one that hasn't caused side effects.  I did have to go off of it for awhile because it wasn't working as well.  I now take it weekly and again it isn't doing what it used to.  My Doc wants me to try Simponi Aria infusions.  The only trouble with that is it needs to be taken with methotrexate (which I was on once before and had to stop because of my liver counts).  I had tried the Simponi  injections and after several months had no relief.  So scary trying new ones as we all react differently.  I am thinking I will ask my theumy if I can stay on the Humira and take a low dose of Prednisone with it.   Wouldn't it be great if they could just figure out a way to give us new immune systems that didn't attack our joints?  That day will come - just in time for many of us.
Posted 11/13/2013 5:09 PM (GMT 0)
Alicat, So sorry you are having issues with your meds, hopefully you will find something that works. Humira works well for me but I cannot afford to take it if the insurance won't pay something, even at that it is too expensive. I cannot take methotrexate or any steroid. I have checked the formulary for drugs that are covered and none of them are covered so maybe the insurance will approve the Humira. I am hoping that will be the case, anxiously awaiting my rheumatologist appointment on Monday! Good luck..hoping that day will come for all of us suffering from autoimmune diseases!
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