Hi, I am new to this website and need some help with a difficult situation.
I have succesfully injected Humira since 2011, bu now need to find an oral alternative as the UK National Health will not support me when I go to live in Malta lterthis year, as the drug is so expensive.
Does anyone know of a suitable alternative in tablet form, Methotrixate did not suit me?
It is me again
I have found a relatively new alternative which is ingested in tablet form, which is an Apremilast called Otezla, approved in March 2014 by the U.S. and is I believe available on prescription. This was published by the National Psoriasis foundation. The problem is I dont know how long it will be until it is available in the UK??
Tinko Diva said:
It is me again
I have found a relatively new alternative which is ingested in tablet form, which is an Apremilast called Otezla, approved in March 2014 by the U.S. and is I believe available on prescription. This was published by the National Psoriasis foundation. The problem is I dont know how long it will be until it is available in the UK??
Tinko, so if you were to go to Malta, how will your health care needs be met when you are there? Will you have any health insurance?
The expense of Humira or any of the Biologic drugs is certainly not one that most of us can afford on our own. The bad news is that Apremilast/Otezla, even though it is a tablet, is in the same price range as Humira. I know, that’s disappointing. You may have no choice but to explore DMARD alternatives.
Here’s another idea though: in countries without drug coverage like NHS, the drug companies often have ways of helping patients defray the cost of medication that is not covered by their insurance. Worth looking into. Here’s a link to start with from Humira –
https://www.humira.com/global/savings-and-co-pay
Hope this helps! Let us know what you find out.
That's a good thought, Seenie, about the Humira co-pay program.
I also got to wondering about reciprocal arrangements within the European Union. Looking at the health section on the EU website it seems that for an EU citizen living in another EU country, healthcare is available under the same terms and conditions as other local residents. So this raises the question of whether biologics are available to local residents. I wonder if it's possible to find a rheumatogist in Malta to begin making this kind of enquiry, Tinko Diva?
This is a really interesting topic so do please keep us posted.
Very interesting topic and it has me, well, interested.
Apparently there is an arrangement, as Jules suggested –
http://internationalliving.com/countries/malta/malta-health-care/
And I saw a medical journal article about the use of anti-TNF (biologic) agents in Malta. So they do use them there.
Tinko, you might want to post another question, something along the lines of “Brits moving within EU – how do you get your biologic drugs?” There are plenty of Brits in places like France and Spain. Some of them must take anti-TNFs (biologics), and some of 'em probably come here!
Thank you both ladies I will use the leads you have given me and let you know what I find out. I am off to bed just now as up early for work but will pick it up after work tomorrow xx
Methotrexate didn't suit me either. I use leflunomide, which is in the same class as MTX, and it is nowhere near as expensive as the biologics. At this point I am on leflunomide AND enbrel, but just more food for thought for you.
Many thanks for that insite, I will make some enquieries about that combination, I think I had tried Leflunomide but not with enbrel, at least it is not a biologic so may be supported by the National Health outside of the UK!
Tinko, I really think there’s a good chance that your Humira could be covered by health insurance when you are living in Malta. Why would you switch from to leflunomide if you’ve done well on Humira?
Here’s a site where you may get more answers than you can get here:
http://britishexpat.com/expatforum/viewtopic.php?f=812&t=21511
Other parts of that site may be useful to you as well.
Here’s the NHS information. (You’ve probably seen it …)
http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinMalta.aspx
That site does suggest that drug coverage may be a problem.
Good luck with this – it certainly is an adventure, isn’t it?
Hi Senie, because we have paid in to the National Health system in the UK all our working lives, we have never cosidered private health Insurence, so while the rules are clear (backed up by the websites you kindly referred me to), there are some circumstances such as my situation with Humira that seem to be a sticking point!
I have applied to join the british expat platform to see if they can help with information, and will be contacting the NHS to ask for help to understand why they are stating that I am covered by my EHIC, but not for what I need !
once again many thanks for your support, I will keep you informed
Tinko, my broad understanding is that the benefit of NHS medical care and drugs is residence driven ... so you're eligible if you're domiciled in the UK.
On the other hand, and again this is just my understanding, the EHIC is issued to residents of the EU as evidence that their respective countries are party to a reciprocal health care agreement so that if you become unwell or need treatment whilst you are in another country as a visitor you can access care on the same basis as the locals. I think the key here is 'same basis as the locals' and this may not be as broad a package of care as we get in the UK, hence the reason that travel insurance is still recommended when travelling in the EU.
As unfair as it is when you've paid your taxes in the UK for your whole working life, and I'm now going to play devil's advocate, why should the NHS pay for anyone who is no longer resident in the UK and contributing to the economy or tax revenue?
There must be thousands of ex-pats with long term chronic conditions that need medication so I'm sure there is an answer to this, even if it's not the one you hope for.
Do keep us informed as this is a fascinating topic. I'd love to move abroad to a warmer climate where I might not hurt so much or so consistently ..... but it needs to be mosquito free! I LOVE Madeira but the mozzies there love me too much for my liking :)
I am so pleased you joined us and raised this issue.
Tinko, I think I get it now, but it is confusing isn’t it? I was working on the assumption that all EU countries have more or less the same package of care. Obviously not.
I’m married to a British expat, and we go to the UK often to holiday and to visit friends. So I am quite familiar with the NHS but this is an interesting issue that I’ve never thought about before. In my reading, I came across something about “channel hoppers”, people in your position who spend enough time in the UK to maintain their NHS benefits. Another interesting thought.
Aside from the research you are doing, I hope that you will also be speaking to your rheumatology team about your dilemma. And if you get to the point where you decide to give another DMARD a go, I hope that you will be able to do so before your burn the Humira bridge. Caution! You don’t want to find yourself in beautiful Malta, but feeling too wretched to enjoy it.
Thanks for telling us about this – it’s an issue that I don’t ever remember seeing on the board before. It’s always interesting to have something new to think about.
Hi Seenie
"Channel hoppers" sounds an interesting option, I will look into that, and I am aware about how hard it was to qualify in the first place to get Humira, so I won't be jeopodising that until I have explored every option!
I have a review due in August and will be discussing all my findings with the new Consultant who is joining the Rheumatology team in May, so could be a fresh set of eyes on the situation......who knows.
My former consultand actually said to me that "it is an unpredictable desease and maybe the sunny climate and relaxed life style will negate the need for Humira" ???!!!.....
Many thanks once more for you help and support
Hi Jules
Absolutely right, they are happy to support me following my years of contribution, as long as the cost is not too high!
I think I will raise the issue with the EU as they are all about the rights of members!!
Thank you for your continued support, and giving me different angles to consider. Unfortunately Mosquitos are par for the course in sunny climes, but take vitimin E tablets when travelling and or eat marmite...it works I kid you not!
Jules said:
Tinko, my broad understanding is that the benefit of NHS medical care and drugs is residence driven ... so you're eligible if you're domiciled in the UK.
On the other hand, and again this is just my understanding, the EHIC is issued to residents of the EU as evidence that their respective countries are party to a reciprocal health care agreement so that if you become unwell or need treatment whilst you are in another country as a visitor you can access care on the same basis as the locals. I think the key here is 'same basis as the locals' and this may not be as broad a package of care as we get in the UK, hence the reason that travel insurance is still recommended when travelling in the EU.
As unfair as it is when you've paid your taxes in the UK for your whole working life, and I'm now going to play devil's advocate, why should the NHS pay for anyone who is no longer resident in the UK and contributing to the economy or tax revenue?
There must be thousands of ex-pats with long term chronic conditions that need medication so I'm sure there is an answer to this, even if it's not the one you hope for.
Do keep us informed as this is a fascinating topic. I'd love to move abroad to a warmer climate where I might not hurt so much or so consistently ..... but it needs to be mosquito free! I LOVE Madeira but the mozzies there love me too much for my liking :)
I am so pleased you joined us and raised this issue.
Love the quote, “It is an unpredictable disease …” No kidding!
Good luck with this, Tinko. Keep us posted on what you find out.
Hi im darren and i too take humeria and im in the same boat im thinking of moving to tenerife and i was also wondering if you can get it on the there own nhs who knows we mite feel better in a warm country