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.