Remicade infusion timing ?

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Shelliesv
Regular Member


Date Joined Apr 2009
Total Posts : 208
   Posted 5/1/2009 9:38 AM (GMT -6)   
For those of you experienced with Remicade, how exact does the timing of the infusions have to be?

I am due for my 2nd infusion next Wednesday but insurance still hasn't approved it. Is there flexibility or does it have
to be exact? I"m feeling better and assuming its the Remicade so I don't want to mess with the dose timing!
37 year old mom of 2.

Diagnosed with Ulcerative Proctitis 1995 (24 years old) / Ulcerative Colitis in 2000 (29 years old)
In remission for 4 years from 2005 - 3/2009 with colazol maintenance only.

Hospitalized for flare 3/23/09 - 3/25/09. Hospitalized 2nd time for same flare 4/17 - 4/22

Current Meds: Apriso 4/day, Prednisone 40mg per day, Rowasa Enemas 2/day, Culturelle

Had FIRST Remicade transfusion in the hospital 4/22/09


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 5/1/2009 10:03 AM (GMT -6)   
Especially during the induction phase it's important to have them as close to on time as possible. That said, I wouldn't take a chance on insurance denying it, because of the expense. I'd get on the phone and try to prod the insurance company.
Judy
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 
.


Shelliesv
Regular Member


Date Joined Apr 2009
Total Posts : 208
   Posted 5/1/2009 10:12 AM (GMT -6)   
Judilyn said...
Especially during the induction phase it's important to have them as close to on time as possible. That said, I wouldn't take a chance on insurance denying it, because of the expense. I'd get on the phone and try to prod the insurance company.


I did yesterday and they said it was just called in Monday and they have 5 days so I don't even have an appointment yet for the next infusion! I'm wondering about the approval - could they possibly say no, surgery is cheaper! That would be terrible!
37 year old mom of 2.

Diagnosed with Ulcerative Proctitis 1995 (24 years old) / Ulcerative Colitis in 2000 (29 years old)
In remission for 4 years from 2005 - 3/2009 with colazol maintenance only.

Hospitalized for flare 3/23/09 - 3/25/09. Hospitalized 2nd time for same flare 4/17 - 4/22

Current Meds: Apriso 4/day, Prednisone 40mg per day, Rowasa Enemas 2/day, Culturelle

Had FIRST Remicade transfusion in the hospital 4/22/09


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 5/1/2009 10:24 AM (GMT -6)   
If it's covered by your policy, they can't deny payment. Unfortunately they sometimes find ways to delay it. Since it is FDA approved, their ability to delay is limited. Call them again next Monday, but if your doctor's office is like mine, they won't schedule until they have the written approval. I have asked the insurance company to fax me a copy of the letter, then in turn I've faxed it to the doctor's office (or driven by and given it to them) before. That can save you a day or two.

Don't panic, I feel sure if you have it a week late it won't have a huge effect. I've had my 8-week infusion as much as 2 weeks late with no problems. I'll get a little more frequency just before, but it clears up after my infusion.
Judy
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 
.


Shelliesv
Regular Member


Date Joined Apr 2009
Total Posts : 208
   Posted 5/1/2009 10:43 AM (GMT -6)   
Well at least I feel better that they can't make the decision (to approve or not) based on whether they think it would be cheaper for me to have surgery! I'll call them again on Monday, that will be their "5 days".
37 year old mom of 2.

Diagnosed with Ulcerative Proctitis 1995 (24 years old) / Ulcerative Colitis in 2000 (29 years old)
In remission for 4 years from 2005 - 3/2009 with colazol maintenance only.

Hospitalized for flare 3/23/09 - 3/25/09. Hospitalized 2nd time for same flare 4/17 - 4/22

Current Meds: Apriso 4/day, Prednisone 40mg per day, Rowasa Enemas 2/day, Culturelle

Had FIRST Remicade transfusion in the hospital 4/22/09


Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3442
   Posted 5/1/2009 10:56 AM (GMT -6)   
I don't think it'll matter too much either- my loading doses were all screwed up also (not due to insurance), something like week zero, week two, then not again 'til week 8! & I've still had good luck with Remicade. What's confusing though, do you have to get approval every infusion? My GI has a woman in his office who handles all the Remicade insurance paperwork- they submit the request to use it AS THE DOCTOR PRESCRIBES, & the whole thing is either approved or denied, not on a dose-by-dose schedule. Know what I mean? Once the approval was set, the insurer sends confirmation to the doctor, then it's up to me to make the infusion appointments at whatever intervals. I haven't actually spoken to my insurer at all since before my first dose.

diagnosed with UC '02
meds-
Asacol- 8 tabs/day
Remicade-10mgs/kg- since 4/07
Imuran- 150mgs/day
various probiotics
Fiber supplement
 
 
 


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 5/1/2009 1:43 PM (GMT -6)   
Mine is approved for a year at a time. Yours probably needs approval because an outpatient infusion is a different procedure than inpatient. They have to keep those rules complicated enough to make it tough for us to be sure what's covered!
Judy
 
Moderate to severe left-sided UC diagnosed 2001.
Flared for 5 years, finally in remission with Remicade since March 2006.
Avascular necrosis in both shoulders is my "forever" gift from steroids.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. 
"My life is an ongoing medical adventure"
 
.


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 5/1/2009 3:58 PM (GMT -6)   
My second infusion was two weeks and three days after the first, because I was traveling.

The doc's office (where I get the infusion) handled the approval, it only took about a week, maybe less. That was after the denial of Humira took more than a month.
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated wheat/gluten from my diet. Probiotics (Ultimate Flora, 50 billion). 
Bad flare in March, seasonal? Back on prednisone 40mg, down to 10mg so far so good... Humira denied, started Remicade 4/12 and doing great~ 


Meesh
Veteran Member


Date Joined May 2006
Total Posts : 619
   Posted 5/1/2009 6:54 PM (GMT -6)   
I'm surprised they didn't approve you for the entire induction period, the several you'll need in quick succession.

My GI did NOT have me get the infusions that way. I don't know why. So you shouldn't fret TOO much over the timing. I had my first one, and my second one was eight weeks later. For the last year though I have been getting my infusions every six weeks as they weren't lasting the two months. In fact, mid-way through the fifth week I am starting to bleed and get some urgency, but I am keeping with the six week schedule.

My insurance company generally approves three or four infusions at a time.

While I am feeling a helluva lot better on the Remicade, I think I want the surgery and not have to take all these meds. I still don't ever feel 100% anymore. If I thought it would get me anywhere I'd ask my insurance company if they'd give me any $$ to keep me going while I am recovering -- in the long run they'd save a lot of money over having to pay for my infusions, only I know it doesn't work that way. So, I am sticking with the Remicade for now while I save my money to cover my expenses while I'd be out of work recovering (self-employed, no workee no money). If I flare while on Remi out goes the colon. First (and last) flare was almost two years before I got it under control. NOT going through that again!!

Meesh
47 yr old female, dx'd UC April 27, 2006; mild arthritis in lower back, dx'd May 2008; Osteopenia dx'd 6/08 Finally achieved remission mid October 2008!!

15 Remicade infusions, current scheduled every 6 weeks: 1st: 7/21/07; most recent: 4/25/09; Current meds & supplements: Lialda, 4 tabs in the morning; Xanax as needed (rarely); Rowesa and/or Canasa; multivitamin w/folate; Culturelle; Fish oil capsules, calcium chews and/or Tums; Vitamin D;

Past meds: Prednisone 4/06-4/08; Entocourt EC; Asacol; Colazal; Venofer (iron) injections Dec '07; Imuran (extremely bad reaction 2/07); Protonix; Lexipro

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