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Ouch cost of Remi; Any Remistart success?

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Posted 4/16/2013 6:35 PM (GMT 0)
Ouch Remicade is expensive. Have many of you looked into Remistart and had any luck with it? Does Remistart reject many or anyone? How long do the rebates take as they sound like reimbursements?

My GI said to look into Remicade and what my insurance covers (I might have to go on it, if my scope at the end of this month looks as bad as before). Looks like I am subject to a $3,000, annual deductible before my insurance pays out anything regarding infusion-based medication (which I assume would be the same for Humira). After that $3,000 is surpassed, they cover Remicade infusions in full. And probably the first infusion would be more than $3,000 if some searches on Remicade costs are true here on HW. According to my insurance company, I guess it is a better deal for me to have subsequent infusions done in the GI's office (only a $30 copay after deductible is breached) rather than at the hospital which would incur other costs.

I know there are several loading-dose infusions within a couple weeks of each other. So I'd be piling on costs until the rebates get here ... ouch... is my head spinning turn

Any other advice from those on here who've used Remi? Should I go down that route... I am not really sure...
Posted 4/16/2013 10:45 PM (GMT 0)
I was on Remicade for almost 2 years. It cost me way too much. It got to the point that I decided I couldn't keep letting those medical bills pile up.

The problem on my side was that the only place I could get my infusion was at the hospital. It was treated as an outpatient thing and my insurance only covered 80-90% of that. Total bills were close to or just over $10,000 per infusion. A lot of that was the service not the medication. After insurance I owed between $400 and $1200, the hospital always seemed to negotiate differently every infusion so the price was erratic.

Humira finally got approved and for a lot of people in my position (I do have good insurance, but still!) they should probably start with this drug first. It works much the same way Remicade does and the success rate is about the same (neither one of the percentages look good to a layman). It cost quite a bit less usually especially since you won't have to pay for an office visit or hospital treatment. It can be done on your own time in your own home and won't take up but a few minutes of your day instead of half a day I spent for Remicade.

For me Humira is $5 dollars (USD). That's $60 after insurance pays (copay) and then Humira Protection Plan takes care of the rest! They even help me with my decent income and insurance.
Posted 4/17/2013 12:11 AM (GMT 0)
My RemiStart was approved no problem.

My Remicade @ 5mg/kg was $6700 per infusion. Insurance paid all but about $700. RemiStart paid the rest.

I have a $1500 max to hit, so it doesn't take too many infusions. I don't know what will happen with RemiStart next year when I get back to $0 on the insurance? Maybe I won't need Remicade then :)
Posted 4/17/2013 3:56 AM (GMT 0)
I also had no issues with RemiStart - it was wonderful. They will want your insurance info (if any) and they will figure out if you have high co-pays for the actual drug. The help you cover the copay for the drug itself but not the infusion staff/technology/etc.

I was fortunate in that my Gi's office (large office with about 20 dr.s) offered Remicade infusions. This cut the drug administration cost but it was still about $600 a pop until my insurance deductible kicked in.

I'm now on Humira for IBD related arthritis and they have a similar program to help defray co-pay costs. I like it sooo much better than Remicade. I administer at home and it's done in 20 seconds. The biggest hassle is dealing with the Mail Order Pharmacy!
Posted 4/17/2013 4:31 PM (GMT 0)
Just so you know before you choose Remicade just because of RemiStart, it only goes so far then you're back with the huge expense! It lasts for up to 12 months or eight infusions, for a maximum annual benefit of $6000. You'll eat that up pretty quick. Your second year will be costly. I don't see this kind of limitation with the Humira Protection Plan.

As far as the specialty pharmacy for Humira, there are a lot of good ones out there. I'm not sure if you can use these guys, but VitalCare based in the state I live is awesome! Very helpful very good people. It has been hassle free with them and they have done all my insurance stuff and took my Humira Protection Plan information and handled that too. They ship my medication overnight in a cooler, gave me free mints, lots of extra alcohol wipes, lots of information, and a free sharps container. They also call me to check up on me, remind me, etc.
Posted 4/20/2013 12:56 AM (GMT 0)
I avoided that cost by getting my infusions ina doctors office, it was only charged as a $35 office visit, if you can believe it. You have to find a doctor's office that does infusions in house.
There was a thread about when my doc sent me to the hospital last time, and when I let them know of the significance to my wallet, they did a work-around.
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