After a truly lousy few weeks with a sinus infection, reduced response from methotrexate, near-constant nausea, loss of appetite and massive fatigue I saw my rheumatologist today. He has a rather pleasing demeanor and a really charming "not impressed" face which he displayed when I told him my long list of complaints. At our last appointment he had ordered the pre-biologic blood screening and x-rays. Fortunately there was no TB or hepatitis, my sed rate was normal and the chest x-ray looked good. I got my first shot of Enbrel in the office today and saw no immediate adverse reaction. He sent me home with my second dose while we wait for the insurance paperwork to catch up. I'm increasing the methotrexate dose to 0.8ml next week and if things look up I hope to be reducing the prednisone dose by the new year. I have my fingers crossed for better days to come with less pain and less fatigue. If things don't look up I'll be looking to have words with for Phil Mickelson.
I am glad for you Jane. I am sitting here thinking I should go for a swim but overwhelmed with fatigue. I am awaiting a prior authorization for Remicade. Hope does spring eternal! I would cross my fingers for you if I could! I will send you warm hugs and prayers instead!
Thinking of you…good luck x
Hope that this works out.
How about I hold Phil and you can........just kidding. I think he is probably a vry nice man.
I wish people would stop bashing Phil. He is a very nice man. He has the same disease as us. He is helping with funding for research. Look up other celebrities that have our disease. You would be surprised on how many are out there. Believe it or not, we need celebrities to fight for us people listen to them. He is lucky for he responded well to the ebrel and this gives people hope that they too will respond well.
Thanks, friends. Oh, I'm not bashing Phil--I hope you know that. He's just the messenger. And the three year old daughter of a dear friend of mine is his biggest fan. She yells "Lefty! My Lefty!" whenever she sees him on TV. How cute is that? Like the golfing version of Dead Poets' Society.
I looked up the price of Enbrel and JEEESH! If not covered on insurance $1,700 a month. $940 month is the contracted rate through my insurance if I were not "authorized" for coverage. If covered it is the highest tier in the formulary. And Enbrel has a rate reduction card--maybe you get frequent flyer miles, too. If I qualify it could be $0 for 6 months and $10 a month for the next 6 months. As I've clearly received an "F" in NSAIDs and methotrexate use I'm hoping my insurance won't be too wiggy about the Enbrel.
Jane what is your insurance carrier? Insurance companies usually have clinical guidelines that state when various treatments, such as Enbrel are considered medically necessary. Failing NSAID's and MTX should be enough, though some carries may require that you fail one more DMARD.
Rebel mom, how do you know if Phil is a nice man or not? I always thought Lance Armstrong is a nice man... until recently.
Hey Andrew
My insurance is processed through Anthem (Blue Cross/Blue Shield). I think it will be OK as I've gone through the other protocols first. I'm trying to locate the plan booklet that would fully explain this process. Thanks for chiming in.
I talked to a rep at the the specialty pharmacy. They say there's no reason that I should be denied and that the 30 day cost is $433 and the 90 day cost is $975. I have to start on the 30 day plan as I'm a newbie on the meds. Enbrel has a "discount card" which she said they will honor and will likely bring my cost to $0 or $10. The same helpful person at the pharmacy said that the discount card is often renewed. I still don't quite understand why this is so expensive but then Enbrel makes it free. Who's getting that kick back? (And I'm NOT suggesting that it is going to Phil Mickelson!) ;)
Oh HAPPY day! Just found out I'm approved and got the financial support from Enbrel. I pay $0 for 6 months then $10 a month for 6 months. This is a renewable rebate so I'm hoping it will last longer than year. I am so utterly relieved. Sending beaming smiles of gratitude out into the universe. Wherever you are, look towards south central Indiana for a moment and feel the warm glow I'm sending!
I can't find Indiana, I can't find Indiana! Just kidding, I am so happy for you Jane! You deserve all the universe has to offer! I am so happy for you!