HUMURA Questions

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Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 8/17/2007 12:34 PM (GMT -7)   
from what I'm reading here it seems like a lot of people have had the option or are on HUMIRA or know someone that is or has. My question is cost. It seems like a costly medicine, is this something not usually covered by perscriptions company like medco or UHC. Or is the copay high. im just a little concerned as to what Im getting into.
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's. Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow through, diagnosed with Crohn's (22 years old 165lbs). Starting HUMIRA 9/10/2007.


genoist
Regular Member


Date Joined Mar 2007
Total Posts : 41
   Posted 8/17/2007 6:36 PM (GMT -7)   
I use Medco, and my copay is $50 per refill, one refill per month, so the cost isn't so bad.
Current meds: 100mg Imuran, Ambien, Prilosec, Remicade (Fourth infusion was 6/4/07), fish oil, probiotics, iron, calcium, magnesium, potassium, vitamin E, and b-12 shots.


curley
Veteran Member


Date Joined Mar 2005
Total Posts : 4305
   Posted 8/17/2007 7:44 PM (GMT -7)   
I am on Humira,but I can't say on the cast because I am on medicade and it picks the whole amount up.There for I have co-pay.
Curley
.........
 


tiredtoo
Regular Member


Date Joined Sep 2006
Total Posts : 25
   Posted 8/17/2007 9:55 PM (GMT -7)   
I have caremark, and the copay is $35 a month. dont like the pens though push way to fast and burns. I use the syringes so I can push at my own speed.

hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted 8/19/2007 6:36 AM (GMT -7)   
I have a plan with Cigna...I start Humira in a couple of weeks.  If I use my local drug store to supply the pre-filled injection pens then I would pay 40% of the cost...and I am told that would run in the hundreds per month.  If I use the Cigna mail order prescription center then they will ship me a 90 day supply for $50.   Easy choice.....the whole cost for one year should be $200.
And the other upside.....for my wife that is....is she gets to stick me with the pen every 2 weeks.....Now if only I can find a way to be sure not to tick her off just before she gives me my dose....
dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
currently on Low Dose Netroxene (started Jan. 19, 2007)...against Dr's wishes, he was pushing for Remicade.  Stopped the Naltrexone July 28th...will start Humira Aug 28th 2006
Crohns is currently active and has been since April of 2005
50 yrs old


Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 8/19/2007 12:04 PM (GMT -7)   
I start about two weeks after you, if you dont mind ill ask you shortly after you start how your feeling.
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's. Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow through, diagnosed with Crohn's (22 years old 165lbs). Starting HUMIRA 9/10/2007.


hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted 8/19/2007 12:08 PM (GMT -7)   
FinalMacGyver said...
I start about two weeks after you, if you dont mind ill ask you shortly after you start how your feeling.

no problem here...my health history is an open book....I figure after the very personal "in-depth" tests we have all been thru there is nothing left to hide.
dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
currently on Low Dose Netroxene (started Jan. 19, 2007)...against Dr's wishes, he was pushing for Remicade.  Stopped the Naltrexone July 28th...will start Humira Aug 28th 2006
Crohns is currently active and has been since April of 2005
50 yrs old


Hayleybaby
Regular Member


Date Joined Aug 2007
Total Posts : 76
   Posted 8/19/2007 2:22 PM (GMT -7)   
I too am on Medicaid so I pay nothing. What I do know is that for the Crohn's Starter Kit it cost about $4700.  I have my kit and it has 6 pens in it. I get my first injections tomorrow morning. 4 pens tomorrow morning--little nervous about the pain and burning though.
30 yr. old dx with CD 10 years ago. Currently on folic acid and azulfadine.  Had ileum removed and resection May 2007.  Just started back to work after being off 13 weeks.  Still feeling lousy.  In the process of trying to get approved to start Humira ASAP!!!!  It scares me immensely!!!!
 
Allergic to: Asacol, Pentasa, Imuran, Paxil, Zoloft, Penicilian, Ampicilian
 
And prednisone does not work for me anymore!!!


Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 8/19/2007 2:42 PM (GMT -7)   
good luck, i'll be in your shoes in the next 3 weeks. Your worry's are the same i've been having. I don't like needles at all.
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's. Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow through, diagnosed with Crohn's (22 years old 165lbs). Starting HUMIRA 9/10/2007.


Aimee =)
Veteran Member


Date Joined Jun 2004
Total Posts : 1020
   Posted 8/19/2007 9:22 PM (GMT -7)   
I have Medco; it's a $40 copay for a box of 2 syringes, which is about a month's supply for me right now.

Hayleybaby
Regular Member


Date Joined Aug 2007
Total Posts : 76
   Posted 8/20/2007 3:39 PM (GMT -7)   
Ok FinalMacGyver, going to be straight with you. Had my loading dose this morning. The first pen hurt like hell and I'm guessing its because I didn't know what to expect. I was so nervous about having an instant bad reaction that I gave myself a mild anxiety attack. I waited about 10 minutes to calm down then the nurse made me give myself the next 3 pens. This probably isn't going to help much for you but during the next 3 pens I used lamas (sp.)(pregnancy breathing) type breathing techniques and that helped me get through them fairly decent. They do burn alot for the first 5 seconds.

I took all 4 pens in the legs. Thank God I've not had any reactions and they only issue I feel rigth now is that both my thighs feel very sore, like I worked out to hard or something. Now I've been told by a couple docs that females have a higher pain tolerence, which I really think is true, but I would choose to do your injections where ever you have more "meat". I think your only options are your leg/thigh area or your stomach.

All in all after getting over the initial nervousness, its not too bad and in 2 weeks I get to give myself 2 pens here at home by myself. That should be interesting.

Good luck.
30 yr. old dx with CD 10 years ago. Currently on folic acid and azulfadine.  Had ileum removed and resection May 2007.  Just started back to work after being off 13 weeks.  Still feeling lousy.  In the process of trying to get approved to start Humira ASAP!!!!  It scares me immensely!!!!
 
Allergic to: Asacol, Pentasa, Imuran, Paxil, Zoloft, Penicilian, Ampicilian
 
And prednisone does not work for me anymore!!!


Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 8/20/2007 4:05 PM (GMT -7)   
Thanks foor the heads up. Im not good with pain at all and the main concern I have is that I will have gotten my self so worked up that it will jump and screw it up at the dr's office. I think Im going to do it on my thigh just because I think the stomach would hurt, more. I guess will see. Thanks for letting me know, it does help.- jason
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's. Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow through, diagnosed with Crohn's (22 years old 165lbs). Starting HUMIRA 9/10/2007.


miraclesivseen
Regular Member


Date Joined May 2007
Total Posts : 169
   Posted 8/20/2007 4:27 PM (GMT -7)   
I HAD NO PROBLEMS WITH HUMIRA, IN FACT I LOVED IT.
FOR THE FIRST TIME IN 7 YEARS I FLT LIKE A HUMAN.
STARTED IT IN MAY, STOPPED IT IN AUGUST DUE TO BREAST CANCER.

AS SOON AS THE BREAST CANCER THING IS OVER WITH I HOPE TO GET BACK ON IT.

CURRENTY I AM ON NOTHING FOR THE CROHNS EXCEPT FOR WELCHOL.

SATURDAY, I WENT SHOPPING AND ENDED UP WITH A MESS IN MY CAR, I HAD TO THROW AWAY ALL MY CLOTHES..I LITERALLY EXPLODED, AND COULDNT STOP OR HOLD IT, IT WAS AWFUL.

I AM JUST HOPING THAT BY THE TIME I AM 50 WHICH IS 5 YEARS FROM NOW, I AM NOT USING A POOP BAG, HAVE NO BOOBS, AND IN THE WELFARE LINE.

THATS ALL I CAN HOPE FOR RIGHT NOW.
Brain tumor 1981
Dx.Crohns disease 1996
bowel resecction 2001
Thyroid cancer 2001
breast cancer .....currently waiting treatment options
seizure disorder .....all my life.
 
 
 
 


Mac_Gyver
Regular Member


Date Joined Aug 2007
Total Posts : 350
   Posted 8/20/2007 5:34 PM (GMT -7)   
Sorry to hear about your recent cancer diagnoses, I wish you the best of luck with beating it. Im hoping that humira will do for me what Ive read it does for others. Time wil tell.
Symptoms Of Crohn's June of '06 (21 years old 285lbs). Colonoscopy in Jan '07 no sign of Crohn's. Surgery for a Fistula in April '07, diagnosed suggestive Crohn's in May '07. August '07 small bowel follow through, diagnosed with Crohn's (22 years old 165lbs). Starting HUMIRA 9/10/2007.


Beth
Regular Member


Date Joined Aug 2003
Total Posts : 303
   Posted 8/20/2007 7:54 PM (GMT -7)   
I use Medco and my co-pay for Humira per month is $20.  I hope it gives you good results. 

Beth


janetpjohn
Veteran Member


Date Joined May 2004
Total Posts : 682
   Posted 8/21/2007 6:11 AM (GMT -7)   
How about if you numb your leg up with a pack of frozen peas or something? Will it help?
Janet

hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted 8/21/2007 8:33 AM (GMT -7)   

Two things...1)  My doc does the load in doses a bit different.  i will go see him on the 31st of this month and the nurse will show my wife and I how to work the pen...i don't think i can give myself a shot...EVER...even using the pen.  My understanding is that the nurse will give me one...then let my wife do the second.  If all goes well...that is it for that day...the next day we do one and the next we do one....then wait a week and do one a day for two days in a row.  that covers the six loading doses.  My doc is not a fan of the 4 in one day thing....he feels it doesn't matter that much.

 

2)  AS A WARNING FOR ALL ON INSURANCE........  about two weeks ago, before I went to see my gastro...I knew that we would probably decide to put me on Humira....Remicade was not an option I was willing to explore.....So as a way of preparing for the new treatment/prescription I called my insurance company CIGNA to find out what would be covered and how much it would cost....I also wanted to figure out the least expensive way to get the drug...my local drug store or thru the mail from CIGNA...I called CIGNA and of course went thru the normal computer voice BS and then after a brief conversation with a real person I was transfered to the "Special Drugs" division.  We spent about 30 minutes on the phone and they confirmed that if the doctor prescribed the drug Humira, they would most likely approve me for it and if I bought the drug at the drug store they would only allow a 40% co-pay....this amounted to $300 per dose or $1928 per 90 days.  If I went thru their mail order service the cost would only be $50 for 90 days worth of drugs.....a no brainer....an obvious savings of over $7,200 a year.  They told me what I would need from the doctor and what I needed to ask his office to do.  They even went so far as to explain to me what the initial dose amounts were and a little about the Humira program.

I do as they say...get two scripts from my doctor called in (1 for the initial dosing and 1 for the 1 shot every two weeks dosing)  the script is suppose to cover 1 years worth of the drug.

I call CIGNA on Monday morning to make sure it has all gone thru and is approved....and it was fine...they only showed one script, but they had blended it all under one number with automatic refills at 90 day intervals...except for the first two.  The first one comes this Friday and the second 90 days worth of maintaining doses comes ten days later.  PERFECT!!!!! So you would think.

Last night....THIS IS THE WARNING PART  I get a call from the mail order pharmacy asking to set up a delivery day for the fed-ex.  We settle on the day and then the BOMB DROPS....the first dose is $1,800.00.  I tell the guy he is crazy, that I had been told $50.00...we go round and round for about 30 minutes...I remind him that I called and checked on this two weeks ago...he says the records reflect that, but the person and people I talked with were wrong, they will need to be counseled and re-trained....the cost is $1,800.00 end of story.  THEN....it gets weird....he tells me that the people i spoke with two weeks ago were not completely wrong, that the second order that was in the pipeline...my 90 day supply....that was only $50.00 and every 90 day refill from then on would be $50.00.  Just the initial dose was $1,800.00 since it was not for 90 days.   I really went crazy then.  I pointed out that the initial dose was 6 shots...and the 90 day supply was the same 6 shots or in some cases it might mean 7 shots.  He could not explain the reason except to say that since I was getting a 90 day supply the first time they would only give me a 40% co-pay.     I said fine...I would cancel the initial order and take the second one since it was a 90 day supply....I would wait 81 days to start, then I would take all 6 shots over the next 9 days and they could then send me the next 90 day supply.  He said that would work.  I said it was stupid!  Then...just as I was about to hang up, he puts me on hold...a minute later he comes back on and tells me that he has just found out that he can over ride the $1,800 price tag and change it to $50.  So now I am getting the initial doses and then the 90 day supply...for the original $50 per script.

I post this as a warning since this whole thing took over 1 hour of fighting on the phone....it makes me wonder how many folks would give up and just pay the higher fee and or give up and not get the medicines the need and deserve......you really have to question almost everything....and if possible question the prices...especially with insurance company prescription services.....If I hadn't checked, rechecked and fought it out...I would be still waithing 3 months from now for my drugs.....maybe waiting forever.

 

 



dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
currently on Low Dose Netroxene (started Jan. 19, 2007)...against Dr's wishes, he was pushing for Remicade.  Stopped the Naltrexone July 28th...will start Humira Aug 28th 2006
Crohns is currently active and has been since April of 2005
50 yrs old


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/21/2007 1:02 PM (GMT -7)   
FYI- I have not taken Rem or Humira but I have used a lot of mail order pharmacies. Usually you have to use mail order to get the best rate if it is a maintenence drug. But, when a maintenence drug is prescribed for the first time, you usually have the option of getting the first dose or two at a pharmacy for a normal sized co-pay while the mail order is being set up. It is only if you refuse mail order and after those first initial dosages, that you get charged the 40% fee. Also, you have to get a 3 month supply at a time. So, I would assume that it would be best to get your loading doses at a regular pharmacy. What a mess. I hate dealing w/ insurance companies.
25 Year old married female.  Diagnosed w/ CD 2 years ago, IBS for over 10 years before that, which was probably the CD.
 
I started getting a ton of junkmail after putting my myspace profile link on here.  Im taking it off but if you want to contact me just email me and Ill give you a link to my myspace.  Sorry!


hspenser
Veteran Member


Date Joined Dec 2005
Total Posts : 544
   Posted 8/21/2007 5:56 PM (GMT -7)   
Thanks Fitzy.....but they ...CIGNA...did finally recognize the error of their ways and have agreed to make my start up dose cost the same as the 90 day script.  I talked with my regular pharmasist and he said that these insurance company pharmacies are putting the regular pharmacies out of business...they are taking all of the high dollar higher profit drugs and offering such steep discounts that the small guys and even Walmart/CVS can't compete.  They set the mail business pharmacies up as a seperate company...discount the price to the consumer to way below the 40% co-pay...then only allow the 40% at the local pharmacy destroying any chance of competition.  They pay their own pharmacy the full price, plus they strong arm the drug companies by telling them what drugs they will approve for coverage and which ones they won't and mostly it is based on the discounts offered.  It is a real scam.
dx IBS 1999   UC 2000   CD 2001
Tested BIOGEN TYSABRI (gave me 2 years of remission)
currently on Low Dose Netroxene (started Jan. 19, 2007)...against Dr's wishes, he was pushing for Remicade.  Stopped the Naltrexone July 28th...will start Humira Aug 28th 2006
Crohns is currently active and has been since April of 2005
50 yrs old


FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 8/21/2007 6:21 PM (GMT -7)   
My dad gets so mad about it. Most drugs are supposed to be kept at certain temperatures (even though I still keep mine in the bathroom). He can't understand how the insurance company can force you to get something mail order when meds are supposed to be temp controlled. What if they freeze on your porch or in a mail truck or roast in an un-airconditioned warehouse on the way to your house. I have never had a problem with mine but he does have a valid point. Plus, mine get left on my porch until I get home. I have no controlled substances but someone else may be curious what is in that box and take off. It is not exactly the perfect system. But, I was told I can have them shipped to my work instead. I just havent bothered w/ that b/c during the school year I only work part time.
25 Year old married female.  Diagnosed w/ CD 2 years ago, IBS for over 10 years before that, which was probably the CD.
 
I started getting a ton of junkmail after putting my myspace profile link on here.  Im taking it off but if you want to contact me just email me and Ill give you a link to my myspace.  Sorry!


grandma scooter
New Member


Date Joined Sep 2007
Total Posts : 3
   Posted 9/11/2007 8:22 PM (GMT -7)   
Anyone facing the expense of Crohn's related drugs like Remicade or Humira  (or any other disease/treatment) that is a Military Vet can go to the VA and apply for medical coverage.  We found out through a friend of ours when he realized Scott is a Vet (Vietnam) that because he put in his time and got an honorable discharged he qualified for thier medical program.  And, it didn't matter what our income was or that we have excellent insurance coverage already.  Scott's a union truck driver.  We get Scott's Humira for an $8 a month co-pay through the mail from the VA Hospital.  The gastro Doc he sees at the VA is also on staff at the UofWA Medical Center, so he's getting excellent care.
Married to Scott who has Crohn's (diagnosed 1988).  I do all the research, go to his Dr appts. and try to keep meds figured out!  His meds currently are Humira 40mgs every other week, oxycodone as needed, oxycotin at bedtime, and Atenolol 25mg a day for the high blood pressure I give him (ha ha).

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