Switching from Enbrel to Humira

I just found out that my prescription drug coverage will no longer cover Enbrel, so my GP is switching me to Humira in January. I'm not too upset as Enbrel hasn't provided the relief that I expected. It worked well for the first 9 months, with steady progress relieving the pain and stiffness. For the past 10 months it has kept me at the same level with no noticeable improvement. My extremeties ( feet, ankles, wrists, and hands) never received the degree of improvement that the rest of my body did.

Also the fatigue has been an ongoing dilemma until recently. (see discussion on Chaga mushroom tea). So I 'm hoping for better results with Humira. Here we go on another adventure. The PSA saga continues.

Gosh, I wonder why an insurance company would cover Humira and not Enbrel?

Good question Seenie. I'm guessing money. The reality of all these biologics is that they work differently for everone, and some just don't work at all for some. All of the biologics now in use, and those that will be introduced in the future, should be available to us all so that our bodies can find the proper fix to our broken immune system.

Some insurance companies are doing strange things with biologics. My insurance may no longer cover my Remicade, instead having me take Humira and fail it before being able to take Remicade (which, once I'm off of, can't go back on again anyway). I'm waiting to see what the new year brings.

Here in beautiful Ontario, our public drug subsidy program will (on a doctor’s explaining why you need it) cover almost any bio except remicade. Who knows what the reasoning behind that is!

One of the big diffences other than that humira actually works so much better for me is the pen. Oh, Enbrel is so much gentler and it clicks when done. The humira pen seems like a stronger spring and only makes a gurgling sound when done no click. Just finished my shot and thought I would share that. Also no fancy extras with the first script but most of the stuff from Enbrel if you use it, like the magnetic calendar and carry case still fits. Curious if that includes a price reduction, lol?! Same price on my copay.

Thanks for the heads-up on the pen Rachael. I won't know the actual cost until the RX is filled as the price is negotiated between my provider and the pharmacy. But in general the cost looks to be nearly the same as Enbrel.

One can always call your insurance company and ask if they will allow you to keep on specific drug, or non generic drug. Often you might need to have your doctor write a letter to them stating how this drug works better for you and why it does.

They do not always allow you to stay on it but they have enough time it is worth a try.

Your doctor should know about asking them and what exactly they need to know etc. Do not take the first rep you speak with decision, you either must speak to another dept or at least manager in representative dept. Again, often your doctor will be able to help you about what dept in what insurance.

You dept of manage health can sometimes help as well but they prefer for you to try and ask your insurance company to allow you to stay on a specific drug.

You may also need to try the other drug they like you go on if you never have. But if you have tried it in the past and noticeably this other drug has helped you where their drug did not, try to get them to allow it through.

good luck and hope it helps.

Oh even Kaiser will work with their patients on this as long as your doctor stands behind it.

That’s very good info Siskiya, thanks for letting us know! Seems like anything that really works is worth a good fight. One of my mottos is there is no harm in asking often you may find things can be possible. Hoping humira matches well for you Alaska. Enbrel never did much but 20-30% For me and I am probably being generous. It helped with fatigue some and with flexibility a little but never for inflammation so pain levels never dropped nor the neuropathy. Humira on the other hand is slowly working wonders. I still have bad days but most are self induced (or employer does induced ha-ha). Good luck!