Humira - how did you get approved to take it?

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Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 6/4/2008 3:18 PM (GMT -6)   
since it's not FDA approved for UC yet.  Just curious, thanks!
Beth, 32 ~ small flare - hoping caused by aspirin - hydrocortisone e's
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 6/5/2008 12:00 PM (GMT -6)   
bump.
Beth, 32 ~ small flare - hoping caused by aspirin - hydrocortisone e's
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 


ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/5/2008 12:03 PM (GMT -6)   
I think, from what I understand, you have to take Remicade first and if that fails then most insurance companies will allow Humira as the next option. Kind of like when they make you take a generic first before allowing the name brand.
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3442
   Posted 6/5/2008 12:34 PM (GMT -6)   
you are correct, ediekristen! Once Remicade fails, your insurance will cover Humira for UC. Of course, your GI has to jump thru hoops, but hey, it's part of the job! They won't cover it w/out you trying Remicade though.

diagnosed with UC '02
meds-
Asacol- 8 tabs/day
Remicade infusions
Imuran- 100mgs/day
Culturelle
 
 
 
 


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 6/5/2008 1:18 PM (GMT -6)   
thanks for the info!
Beth, 32 ~ small flare - hoping caused by aspirin - hydrocortisone e's
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 6/5/2008 4:09 PM (GMT -6)   
Actually, it depends on your insurance coverage. Many policies specifically exclude medications that are used off label from coverage. In those cases, it's usually impossible to get coverage. So read your policy or check with your benefits coordinator at work. My coverage is very good, but does have that exclusion in it, and I was never able to get approval for Remicade until it was approved by the FDA. Believe me, I tried everything including submitting a detailed five-year cost analysis showing that Remi would be cheaper over that period than surgery. No dice.
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


ediekristen
Veteran Member


Date Joined Apr 2007
Total Posts : 1366
   Posted 6/5/2008 4:17 PM (GMT -6)   
Good point, Judy. I didn't think about that aspect. My new insurance is the same... The coverage is pretty great for everything, except they don't cover contraception of any kind, infertility treatments of any kind (although they pay an amazing amount for pregnancy/newborn costs...hmm) and nothing that's off-label/not approved. There was some other things that I thought was strange but didn't really apply to me so I don't remember. Insurance is such a huge pain though.
Female, 22, Ulcerative colitis (pancolitis) since 1999; GERD; gastritis; osteopenia in hip & lumbar region of the spine from long term prednisone use.

Current Meds:
10mg Lexapro (for depression/social anxiety)
Digestive Advantage: Crohn's and Colitis formula (2 pills per day, started 5/14/08)
125mg Azathioprine
4800mg Asacol (Four 400mg tablets, three times a day)
 
 
 


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 6/5/2008 4:21 PM (GMT -6)   
I know, Edie, I got a little dramatic with them on the phone one day and said "I guess it's cheaper to let me die, eh?"

But I know they're just doing what their contract with my employer provides for. They really don't have a personal vendetta out for me. Sometimes it just feels that way....
Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Asacol, Rowasa, Pentasa, Prednisone, Entocort, Azathioprine
Avascular necrosis in both shoulders is my "forever" gift from steroid therapy.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


kb5
Veteran Member


Date Joined Jan 2007
Total Posts : 1015
   Posted 6/5/2008 4:33 PM (GMT -6)   
Are there Humira trials going on? I know that's how many got on remi before it was labeled for UC or Crohns.
Kelly, 30

Left sided UC diagnosed 1/98 age 19, Pan colitis diagnosed 1/07
Currently on 4x3 Asacol, no more pred after two years!!!! Off imuran as remicade is working!
Prontonix once daily for acid reflux, zofran 8mg every six hours for nausea
Remicade started 3/1/08...just had 4th infusion


fitmom00
Regular Member


Date Joined Mar 2008
Total Posts : 113
   Posted 6/5/2008 5:22 PM (GMT -6)   
My doc is doing a Humira trial, as well as a Colal-Pred trial and he said for me to choose which one I want. The colal-pred is obviously much safer, and only lasts 4 weeks. But, at the end of 4 weeks, you're S.O.L. and the drug won't be out for a couple of years. With the Humira, it's a one-year trial, everything paid for, etc. But I'm terrified of the side-effects. Check out www.clinicaltrials.gov and see if you can find a trial close to you.
Renee
Diagnosed w/ UC in August 2007
Current status: Flare

4 Lialda/day, steroid enema at night, Wellbutrin XL


Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3442
   Posted 6/5/2008 5:56 PM (GMT -6)   
see, my insurance (I have Harvard Pilgrim HMO) also will not cover the off-label/unapproved drugs, but my GI told me that if everything else fails the doctors can get the insurers to cover it. Of course, he was told this by the Humira rep, so it may not be true! But I think when I started Remicade it was not covered for UC, only Crohns, & we did get full coverage. I'm lucky in that way, my infusions don't cost a thing. And funny enough, while I was at the infusion room this past Tuesday at my hospital, the nurses were talking about billing. They bill Remicade as a chemo drug! I'd talkw ith your GI- chances are, he's dealt with this before. I know my own GI has one specific nurse who does all the Remicade billing/scheduling, etc.
diagnosed with UC '02
meds-
Asacol- 8 tabs/day
Remicade infusions
Imuran- 100mgs/day
Culturelle
 
 
 
 


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 6/6/2008 8:32 AM (GMT -6)   
crikey! What a mess! I will check this out next week w/my benefits provider. It's scary to know I am one more drug away from surgery. B/c I can't live my life like this, I just can't.
Beth, 32 ~ small flare - hoping caused by aspirin - hydrocortisone e's
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07 - partial remission since 03/08
Prednisone 5mg 1xday (tapered from 60 = ), Simvastatin 20mg 1xday, Diovan 160mg 2xday. Enalapril 20mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 

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