Spondylitis Association of America Forums General Discussion General Message Board for Ankylosing Spondylitis and Related Diseases Decision on TNF

That's interesting - since Remicade is mixed and administered via IV infusion at infusion centers/hospitals, I can't imagine it could even be dispensed by a regular outpatient pharmacy.

As for ordering 3 months of Humira - most docs like to see people try it for 3 months or even 4, before deciding if it worked or not. Of course, some people (not many) have side effects or reactions severe enough to never take a 2nd dose; but many rheumies can offer a few free sample shots to get things rolling.

This community is just wonderful. Filled with knowledgeable and caring people.

I have tried filling out all those forms, only to be told that I don't qualify. Either it's because I have insurance, or do not meet the financial criteria. I really only wanted assistance with the co-pay, which some of those organizations offer, but again, I don't qualify.

With regard to the pharmacy price, I hadn't thought about that,and my doctor didn't say anything. I'm not sure she is aware of the exact protocol for Remicade in this practice. She is fairly new to it, and out of NYC Special Surgery where everything can be done in-house. As far as trying the Humira, I wouldn't want to have any kind of reaction, which probably wouldn't happen, but then have two doses left which no one will take. That happened with me when I used the Enbrel. I had three doses left. Fortunately, I knew someone using it as well and gave it away. It would cost about 2800 or so for the three month supply. As I said there is a big difference between Humira and Remicade.

Will be calling the hospital to see if I can get additional information.

Again thanks for all the input it's making my decision a little easier.

I understand you wouldn't want to risk having a ton of leftover Humira. That scenario is exactly what happened to me with Enbrel - I had site reactions (which I now know is relatively common and can sometimes be overcome with Benadryl & patience) and switched to Humira after 3 injections, leaving me 9 that I literally could not give away - and I tried!! Same as you Sorry if I wasn't clear, what I was trying to say is if you tried Humira, maybe your doc could give you a few free samples as a start - I think that is common - and then if you had no issues you could order 3 months' supply.

Hopefully the hospital won't be coy about their contracted fees with Medicare...

Jen, what do you mean about the hospital being "coy" with the Medicare information? I am assuming from what I have read here that I can't bring in the Remicade from a pharmacy. Which, I think, means that there will be a drug charge along with the infusion charge. Hopefully, I can get some definitive answer.

If I can't, maybe the doctor can. Jumping through these hoops is just so much fun especially trying to squeeze it in between working etc.

Oh Well!

rheumys can get samples of humira pretty easily. I was offered samples at each visit when I as on it.

you can't get remicade from a pharmacy, thats correct.

you can call the hospital or infusion center where you would get it done and ask the cost. I don't know much about medicare, but is there a phone# you can call and ask about your cost share for the med and infusion?

Remicade is covered by part B meaning after your deductible you are responsible for a 20% copay. Your supplement should pickup most of that heres a primer:

http://www.janssenaccessone.com/pages/remicade/guide/medicare.jsp

Any of the other bios are under your part D and that is a real crap shoot. is something to keep in mind during open enrollment period (same with supplements) I'm not aware of any company assistance programs that provide copay assistance to medicare. That is pretty much prohibited by various regulations.

this right here gives info for assistance for those in medicare.

Can't tell you guys how much I appreciate all this information. I have tried the different prescription assistance plans, but I am not eligible either because of insurance or annual income. The programs stay as close to the poverty line as possible, which I am sure makes sense. It's too bad that there isn't some sort consideration for those not at that line, but could definitely use the help.

Economically, Remicade seems to make more sense. Hopefully, it'll do its job. With my co pay Humira will be about $800 per dose, which is a big nut to crack.

good luck acroce, keep us updated!

and YES< there is no real aide for the middle class in the assistance programs.