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Cost of Humira...YIKES

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Posted 3/11/2010 2:55 PM (GMT 0)
     The pharmacy just called to let me know my co-pay for the starting kit of Humira....$948!!!!!!  This just blows me away since I only paid a $5 co-pay for my Remicade infusions.  I wouldn't mind if this would be a sure thing but be darned if I want to pay that kind of money and it fail like Remicade did.  I am so upset over this.  Please help.

     By the way, my insurance is Personal Choice Blue Cross and Blue shield and I live in south Jersey.

Posted 3/11/2010 3:15 PM (GMT 0)
Ouch. I am dealing with a similar thing but with the Remicade-I have to pay 10% up to my $2000 deductable, but I got started in the Remistart program, which will pay for quite a bit of that.

Anyway, I know there are assitance programs for Humira as well, though since I got mine through a trial, I don't know all of the details. Here is a link with a number you can call about it-and I do think there were some other posts about this very thing-I'll look and see if I can find them for you.

http://www.humira.com/Global/FinancialHelp/Default.aspx
Posted 3/11/2010 3:15 PM (GMT 0)
Did you sign up for MyHumira?  Use their copay card?  I just got my starter kit but it didn't cost me anything.  I know the next one will because my deductible started over March 1.  I have to pay $4500 deductible.  Had to stop Entocort because it will cost me $1100. My Asacol is $652.  Good luck Christine.  I just took my second set of shots yesterday.
Posted 3/11/2010 3:38 PM (GMT 0)
That is more then my copay for Remicade...you would think Humira would be cheaper since you don't have to be infused??
Posted 3/11/2010 3:50 PM (GMT 0)
Yeah, Christine I would definitely check out Humira's assistance program. It's really easy to get into to - they don't ask about income or anything. I was thinking my card was good for up to like $500 a month. The first month will be more expensive because there are more pens. Through that program I pay $5 a month.
Posted 3/11/2010 3:54 PM (GMT 0)
I know nothing about your insurance, but that's your copay?!?!?!? Usually Humira falls under the prescription drug coverage, it's just like any other script you pick up from that pharmacy. I know my insurance has tiers, they run from $30-$90 per script. I only pay $30 for each Humira order, which I thought was a lot, after getting REmicade for nothing for years! Don't take what the pharmacy says, call your insurance company directly & figure out how exactly they cover Humira- a medical benefit, prescription benefit, etc. I have never heard of anyone paying that much for this particular drug, it's got to be a mistake.
Posted 3/11/2010 3:56 PM (GMT 0)
It's the screwy way insurance figures things. Since you give yourself the Humira, it's charged as a medication, so you pay whatever your medication co-pay is. Mine would be $35 for a month's supply. With the Remicade, it's charged as either hospital treatment, office visit or chemotherapy, depending on your insurance. Usually there are different charges for each of these. Often the insurance company doesn't even know what it should charge. Last year my Remi was charged as hosptial treatment, this year it's chemotherapy and costs me nothing.

Do try for the assistance program to see if you'll qualify. If not, then you can make a decision based on all the facts.
Posted 3/11/2010 4:04 PM (GMT 0)
As you know my son works for Abbott.  Check out the assistance program - it is not only for poor, etc. as Humira is very expensive.  You should be able to get some help.

I hope so!

ElaineNY

Posted 3/11/2010 11:55 PM (GMT 0)
     I called my doctor's business office.  The woman said my doctor should never have even written the script but sometimes these doctors know nothing about how the billing works, so I will give him the benefit of the doubt.  I was his last patient yesterday, he squeezed me in at the very last moment for the sigmoidoscope, plus he was very upset because he thought he saw a tumor in my rectum which, thankfully, turned out to be just swelling due to the inflamation.  Guess he just wasn't thinking.  Anyway, his billing office said they go through a company called ITSRX.  This company gets in touch with my insurance company and I suppose they work something out.  She told me to just call the pharmacy and tell them NOT to place the order.  WHEW!  Good thing the pharmacist called me first to let me know the cost.  All my husband did was drop the script off!!! Sheesh!  This process should take about 48 hrs.  I am to phone her on Tuesday to find out what my cost will be.  I was wondering, if the doctor's office gave me the shots, couldn't that be listed under office visit?  This is why I only paid $5 for the Remicade.  It came under my co-pay for the office visit.  Thank you all for your help.  If it is still too expensive through this ITSRX I will try these other options.  God bless you all!!!

     By the way...today was a "great" day..lol.  No poops....did tons of chores.  Hubby just can't get over this!  Neither can I.  See what happens tomorrow.

Posted 3/12/2010 12:01 AM (GMT 0)
Humira isn't yet approved for UC, so to get it covered, you'll have to get special approval. That's likely why the cost was so high.

Anyway, glad you're having a good day!
Posted 3/12/2010 2:25 AM (GMT 0)
yeah, last year my GI had to write a letter to my insurance company requesting coverage for humira (stating that remicade was no longer effective and that the only other option was colectomy). my insurance reviewed & approved it in 10 days - at this time my GI wrote the prescription. i then contacted a specialty pharmacy that carries humira who negotiated the cost with my health insurance, and my co-pay ended up being $30 a month.

good luck to you as always
Posted 3/12/2010 6:05 AM (GMT 0)
another thing may be the blue cross blue shield and it only being march. I have BCBS coverage in alabama. before the my insurance covers any Rx costs I have $800 to pay out of pocket at the beginning of every year. If yours is set up the same way it could possibly be that you havent met your out of pocket deductible for this year to get coverage yet.
Posted 3/12/2010 1:34 PM (GMT 0)
     Brad...I have no deductable with my Personal Choice. Actually, it is an excellent insurance.  My husband worked for Temple Univ in Philly for over 34 yrs.   about ten years before he retired he had the option to pre pay for our health insurance so we would be totally covered until Medicare kicked in, then the Personal Choice would become our secondary insurance at no added cost.  Little did we know I would have this horrible disease.  My husband is eight years older than I am (he'll be 72 in May).  God blessed him with good health.  He takes Nexium for upper gastric problem but that is it.  I never had to pay a dime for all the tests my doctor ordered over the past eleven years nor a penny for either one of my hospitalizations.  No cost for blood work either.  I do have to pay 10% of my prescription pill costs but get the generic.  So, you can imagine the shock when the pharmacist told me $948 for the Humira....lol.

     I have two cousins down in AL...they are darn Yankees..lol.  My first cousin lives right outside Montgomery.  She is 80 yrs old.  She and her husband moved down there five years ago to be closer to her son and daughter in law.  Her husband passed away last year and she absolutely is lost down there.  Coming from North Jersey it was a culture shock to her...no bagels, no hoagies...what a dilemma.  Her son lives in Wetumpka.  He met his "southern belle" while attending college down there and never returned to Jersey.

Posted 3/12/2010 2:08 PM (GMT 0)
christine when i first got on humira my insurance approved it for all of 3 days before they denied it becouse its not approved for UC, i had taken the first set of shots in the hopsital and was worried that it was for nothing becouse my insurance would not cover it. i went through different people at the insurance company voicing my concern and through their grievance committee, and my doctor even wrote a letter to the insurance company, but all i got for my trouble was a denial letter. my doctor told me about abbott patient assistance, so i got the necessary information, i think it was tax return paper, insurance paper, insurance denial paper, and dependant papers, faxed them or mailed it to them and within 2 weeks they mailed the medication to me. you might at least try it through them to see if they can help with the cost at all. also my doctor had told me about a prescription card from humira to help with the deductible from insurance companies, if your carrier will even approve it. sorry i hope these suggestions may help you

heathd

Posted 3/12/2010 3:37 PM (GMT 0)
Just found out my copay for Humira is $345. Asacol will be $652 and the Entocort would be $1100. Can't afford all of them so I hope he Humira kicks in quick.
Posted 3/12/2010 4:07 PM (GMT 0)
Those are crazy charges for med!.. Thankfully I live in the UK!!
Posted 3/12/2010 5:01 PM (GMT 0)
Boxermom, with the Humira card your co-pay should be $5.
Posted 3/12/2010 6:45 PM (GMT 0)
That price is with the Humira card.  Not sure why but that is it.

Posted 5/9/2014 11:02 PM (GMT 0)
Recently started Humira for psoriatic arthritis, and same thing here. After only paying $5 for the first script, I hit a brick wall with Walgreens and Blue Cross trying to get a refill. Endured 6 days of phone calls and probably 3 hours of wait time, only to find out my cost was $1200. With the co-pay card it's now $600, but still astronomical. The whole problem is the insurance plan I have through work - find out what your "specialty pharmacy" coverage is. If your employer can upgrade to a better plan, it's a huge difference. In 2 months, my cost will drop to $60 a month. Until then, I have to just say charge it...
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