HealingWell
Search Close Search
☰

Xeljanz Update

Support Forums
>
Ulcerative Colitis
✚ New Topic ✚ Reply
1 2
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/11/2017 8:00 PM (GMT 0)
Hi Suzy!

Just reading through this post and I've also been interested in Xeljanz. My GI here in Houston at the Ertan Digestive Center is looking into it today but it's taken me doing a lot of pushing to get it. I take it your husband is still doing great?
Posted 1/11/2017 9:01 PM (GMT 0)
Hello.

Husband is still completely in remission. Amazingly we only had to go through one appeal with the insurance company to get it covered. Probably because he had used all the other approved biologics and had surgery scheduled -- the meds are cheaper than three surgeries for a j-pouch. Good luck and let me know if you have any other questions.
Posted 1/12/2017 6:47 PM (GMT 0)

suzy-q said...
Hello.

Husband is still completely in remission. Amazingly we only had to go through one appeal with the insurance company to get it covered. Probably because he had used all the other approved biologics and had surgery scheduled -- the meds are cheaper than three surgeries for a j-pouch. Good luck and let me know if you have any other questions.

I think that my surgeries were in total over $600,000 paid out by my insurance company and 50+ days in the hospital.

The meds aren't cheap either, my current insurance company pays out about $110,000 a year for my annual Stelara costs.
Posted 1/12/2017 8:24 PM (GMT 0)
Wow re Stelara! I have read that the Xeljanz wholesale price is $2500 / month, however, the pharmacy charges my insurance company $7,500 / month. It is the most valuable item in our house!
Posted 1/12/2017 8:51 PM (GMT 0)
Suzy,

I don't want to thread-jack too much but my 2 month supply of Stelara is paid at $17,397.55 (original costs before discounts $37,128.93). I take a double dose (90 mgs) which is the FDA approved dosage for CD.
Posted 1/12/2017 11:56 PM (GMT 0)
I am so happy people are having luck with xeljanz!!

I personally feel like surgery was so much cheaper for me. In time, energy and actual dollars. I spent a few 1000 on surgery - could have spent 0 if I used an in-network doctor, but chose someone out of network. Over the years with UC, I was spending my max out of pocket every year + deductible, which was a few 1000 per year - plus a lot of additional costs (like time, poor QOL, reduced ability at work, cost of traveling to doctors, parking...), and there was no end to it. Since surgery, I spend next to nothing on health stuff.
Posted 4/18/2017 9:01 PM (GMT 0)
Hi Suzy,

I hope you see this message or anyone else who has experience. My insurance is not allowing Xeljanz and I am working with Hopkins to get it approved, does anyone know what or who I can contact or do?

I am in the similar situation with your husband, only surgery left.

Please help!
Posted 4/19/2017 6:02 PM (GMT 0)
One thing I liked about working with Johns Hopkins staff is that they are on top of the insurance approval process.

You always get rejected the first time, especially since Xeljanz is off label.

If you have tried and failed at everything else, hopefully you will get approved. Your doc will write the appeal if it becomes necessary. Also, if you get your insurance through your employer sometimes they can help too. Let me know what happens.
Posted 4/19/2017 6:30 PM (GMT 0)
If you can't get Xeljanz approved, I'd continue the process until you've exhausted all your appeals for Xeljanz since you already started it but it would probably be easier to get Stelara because it is already FDA approved for CD. If you haven't tried stelara yet.

Suzy is correct, since it is off-label you will get an automatic rejection. Then your GI has to write a letter of medical necessity for the Appeal. You have a good chance of getting it approved if you've tried everything else. Sometimes they will still reject it and you'll have to file another appeal and your GI will do a conference call with the insurance company's doctors on staff explaining your situation and why you need Xeljanz.

Don't give up hope but it is a 2-3 week process if things don't slip through the cracks....stay on your doctors office and keep asking for updates.
Posted 4/19/2017 6:54 PM (GMT 0)
Suzy do you mind sharing me what insurance and physician at hopkins you were able to work with?
Posted 4/19/2017 8:55 PM (GMT 0)
Dr. Lazarev -- GI in Baltimore. I have Blue Cross/Blue Shield
Posted 10/9/2017 9:33 PM (GMT 0)
I was just approved for Xeljanz after failing Entyvio and becoming steroid refractive. Any updates on the Xeljanz front would be greatly appreciated. I'm hoping it will help pull me out of this 6 month flare.
Posted 10/9/2017 10:04 PM (GMT 0)
My husband is on Xeljanz 18 months now. Still in full remission. No apparent side effects. Feels himself. He knew within about two weeks that it was helping. Good luck. He takes 20 mg a day -- 10 mg in the morning and 10 in the afternoon.
Posted 10/24/2017 10:58 AM (GMT 0)
My insurance approved Should start in next few days. I’m staying positive. 30percet of colon has ulcers and of those ulcers 75percent are ulcerated sad
Posted 10/24/2017 12:11 PM (GMT 0)
Good luck!
Posted 10/26/2017 1:45 PM (GMT 0)
Suzy-Q what was his stool like before, mushy and thin with blood and is it totally normally now? Odd questions, LOL but me, remission would mean pre-UC/Crohns stool, dry, big and long. I hope I get that too and SOON!! I'm in rough shape right now. I too am taking 10 mg twice a day.
✚ New Topic ✚ Reply
12