Biologic Decision

Verifying price with my insurance now. If Humira does get me in remission how long can I expect it to work??

I suggest that you go to Humira's website & read the information about their assistance program. Back when I was on Humira it took care of my co-pays. The website is very informative.

No one can answer your question about how long you can maintain remission on any of the medications, this includes your dr. We all respond differently. However, you can use the search feature at the top right & type in Humira & UC, you will find many threads of members having success with it.

There is a member in the crohns forum that has been on Remicade 20 years, Humira is like a sister drug to Remicade.

You are correct about Medicare part d not allowing any assistance programs. However that is for the lowered cost copays programs. Most of the manufacturers have 2 assistance programs. One is a lowered cost copay and the other is a no pay free program. You might have to call them to ask My experience is it’s very easy to qualify income-wise. The paperwork is a bit of a hassle and has to be done yearly but it’s well worth it in the end. I am currently receiving Aimovig (migraine preventative shots) at no cost.

Also as a data point on Medicare plus a plan f supplemental a biologic administered by infusion are covered under medical side, not part d prescription plan. So if you have plan f remicade or entyvio would be fully covered. I have no copay on my entyvio infusions.

Hi,

Sorry to hear you are flaring. I would agree with everyone else to check out patience assistance programs. I dont know the circumstances if you are on medicare. I would hope they would still have something. Im on private insurance (weird plan where I pay all expenses first until I reach my deduction) and I use the patient assistance program for another biologic, Entyvio. It works great and I pay nothing for the drug (minus the cost to admin it).

I was on Humira before Entyvio and unfortunately never received any benefits from it. I liked it because it was easy to do and give to yourself. The first time you take it, a nurse will come to your house and work with you to make sure you are doing it correctly. With COVID, Im not sure how that will work. I would imagine your doctor could show you.

Taking the shot is easy. A little pinch and it usually is fine after the first couple you do. I always took mine in the leg, but some people have sworn that taking it in the stomach is better for it working. Not sure how that works, but I would take it where your comfortable, either the leg or the stomach.

Hopefully you get some good benefits from it. Good luck!

I would tell you to try a biologic. They have helped a lot of people, including me. There are many options that can hopefully work while fulfilling medicare.

I really dont know about what process doctors use to decide which biologic to use. I try Humira first and then Entyvio. Im not sure the order matters so Id bet a plan could be developed where the best biologic could be determined for your situation.

Yes there are several infusion biologics available now. Remicade is the oldest one with a good track record if that one interests you, in the event you find Humira too expensive with the co-pay. This should be discussed with your dr if it comes down to that.

I suspect your gi will want you to try a biologic to see how you do before making a recommendation for surgery. If you fail a bio then your dr will be more inclined to send you for a surgical consult. A lot of insurance company's require a patient to try the bio's before they will consider approving surgery. Medicare may not be any different.

Hospitals right now are stopping elective surgeries due to the virus. A surgeon has to agree surgery is the only recourse, after that an anesthesiologist has to agree to you being his patient. Whether we like it or not, once we get to the ages we are now, being put under anesthesia is a risk & some drs want not part of us unless it's an emergency.

I would rather take a biologic any time over prednisone. Long term effects of prednisone are not good, osteoporosis, diabetes & glaucoma, no thanks. The last time I was put on prednisone was in a hospital setting. My sugar went sky high & I was getting 3 insulin shots a day. My family had a heck of a time convincing the drs I was not diabetic. I have osteoporosis of the spine & have lost several inches in height. If you have not had a bone density test to check for osteoporosis your gp should send you for one, especially with your long term use of pred.

Take care.