I have Cigna insurance and they sent out a letter saying they won’t be covering remicade after june 30th and are suggesting bio similar drugs.
I just started remicade a couple of months before (in march) and i got into remission after being hospitalised for 10 days. Can anyone suggest next steps to continue to stay on remicade? Is it good to get enrolled in patient assistance program now?
I am very familiar with this situation, but good news, YOU DONT HAVE TO SWITCH! I kinda do this Monday-Friday, so listen closely. Call your doctors office, tell them you don’t want to switch to a bio-similar and you want to stay on remicade. Tell them they will have to submit a Letter of Medical Necessity to Cigna specifically stating why your condition requires you continue therapy with remicade. Since remicade has dropped off Cigna’s formulary (fancy word for list of preferred drugs) your doctor will have to submit a “Formulary Exception Request” along with the Letter of Medical necessity. If the nurses are confused have them contact their Field Reimbursement Access Specialist or their Janssen sales rep. If your doctor’s office staff is willing to do the leg work, there’s zero reason you can’t stay on a medicine that’s working for you. Trust me, I’ve seen this overturned many times already.