First post - strange (but good) experience this morning with Accredo

General Medications
1

Hello. This is my first post here, so I'll give you some back story...

I'm a 39 year old male who was diagnosed with psoraisis at 18 months old. I don't have it as bad as some, patches on my knees, shins, calves, elbows, hands once in a while... gets worse and better at various times for various reasons, you know how that goes.

Over the last year I noticed some joint issues... it started in my toes, one on each foot, swelling and pain. My initial thought was gout. Then one wrist... and one finger... so I asked a podiatrist friend of mine what he thought my toes looked liked. He said it looked to him like psoriatic arthritis and that it was time to go see a rheumatologist. So I did...

Sure enough, I have PsA. It's early enough that no permanent joint damage as occurred thankfully. After some discussion and testing my Dr. would like to put me on Humira. This is where it gets interesting...

I have a Consumer Health 90/10 plan for insurance from work. There is a decent co-pay for the family and an HSA. Accredo calls me today to talk about costs. After insurance the initial cost was $855 and then $700 a month after that...

Time out jack. Say that to my good ear? The woman on the phone was very nice and understanding. I explained that I really just couldn't afford that. Then she asked me if I was receiving assistance on any other medications at this time... I'm not, so she asked me if I wanted her to get me approved for an assistance plan... well, of course. :-)

She put me on hold and a few minutes later informed me that I was approved by a company called Opus Health. They were going to cover $9000 a year and it would only cost me $5 a month. Naturally my first question was "what's the catch?". No catch she says... mmmm hmmm, I asked if I would be approached by some Italian gentlemen and some time in the future with a favor I needed to accomplish and couldn't refuse...

So here are my questions:

Has anyone worked with Opus Health?

Am I selling my soul on this one?

Any issues with Opus Health?

Sorry for the novel, thanks for reading!

TL:DR - Humira went from costing me ~$800 a month to $5 a month and there is "no catch".

2

You're not selling your soul. Or a kidney. You're doing what we all do and pursuing a prescription assistance program. Opus Health manages the HUmira prescription assistance program and, yes, it really is a $5 copay. This kind of plan only works if you have private insurance int eh US. If you're on Medicaid then it won't work. Accredo is helpful in getting this kind of stuff figured out with patients and I'm surprised your doctor didn't tell you about it when s/he wrote the script. But I'm still not giving them a wholly positive endorsement!!

3

No catch. Good luck with the Humira. Might as well go for broke because of the P and ask for a loading dose.................

4

You are lucky, lucky and lucky. Your podiatrist knows his stuff. Your rheumatologist cut to the chase and suggested aggressive treatment right away. And your insurance company hooked you up with the assistance plan.
With that kind of luck, you need to book a weekend in Vegas!

5

Your rheumy must be from the same school of thought as mine! Anyway, I take Enbrel and Opus Health manages my Enbrel Support! I pay about $16 a month for Enbrel, which for the first three months was over $5,700 a month (2 injections a week). Crazy good benefit!!! No strings attached!

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P.s. You will get a "support card" and accredo will need the number off that . They told me I will need to re-register for Enbrel Support every 6 months, so I'll be doing that in December.

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Just a note here, that there are other financial assistance plans available for medications some of us take. From our Newbies’ Guide –
http://discussion.livingwithpsoriaticarthritis.org/forum/topics/co-pay-assistance-cards

8

Thanks for the replies everyone! I should get a call from Opus Health today or tomorrow to get the process rolling. I'll update when they do.