Remicade - Over $3K a month! Help please

[sosimplenow]

Help, please. My daughter has Crohns. She's in the hospital now and hopefully will be coming home soon. They want to put her on Remicade. I just found out it is over $3K a month and our insurance pays 50%. There is NO way we could come up with 1500 a month. Does anybody have any suggestions??? Thank you.

[carisal]

My dad is on Remicade for Ankylosing Spondylitis. I'm just replying here so my mom can find your post when she comes back online.... she may have some advice for you.

[cheynesnana]

Check this site ....seems to be some sort of payment assistance program... hopefully you will qualify..

centocoraccessone.com - Patient Resources

[sosimplenow]

Thank you so much....you don't know how much it means to me!

[#1RobThomasfan]

wow bless your daughters heart, I think its just ridiculous how much these drug companies charge for medicine...let them prove to me it cost them even 1/10 of that to make that ONE script then I'd pass out. I hope you get the medication at no cost to you. Bless your heart.

[crecian]

first, it is not usually a monthly dose, except maybe in the beginning for the first three doses...but, as carisal said, my husband is on it for ankylosing spondylitis, not chrones so the doses may be different.
second, it is an infusion done at the md office, you can not administer this at home, and you will be charged an office visit copay, you will not be using your pharmacy benefits on this. (we pay our $30 office visit copay each infusion)
so hopefully you have good coverage for office visits, does she see a rhuemy? that is who administers this for my husband, make sure they have the prior authorization from your insurance company before the first dose, and will probably need to get a new auth every dose until the ins comp figures out that it will be routine then they will give longer auth's.
It took the md writing a letter to our ins comp to authorize the first one because it is so expensive they don't want to pay.
and as a pp said there is that assistance program that you may qualify for, they help to cover what your ins won't.
good luck, pm me if you have any other questions.

oh, want to add that my husband started on Remicade when it was brand new and still not approved by CMS (Medicare, which is what a lot of ins look at when they decide to pay or not) so that may be why it took a letter from the md to get the ins to pay for it. that was years ago.

[canadamom]

AARP part b pays it in full. You also might check it is generally every 8 weeks and should be about $1100 which is still a lot.

[motherofall6]

i havr RA i was on remicade and now on orenica. they are both biologic drugs , so ask her doctor if she can go on orencia instead, then sign up at orencia.com and sign up for there co pay assist. program which pays her copay in full for 6 months, and if u r not satisfied with orencia after the 6 months they will pay up to $5000 for the 1st month on a different biologic .
here is a link of drug coupons to save money on prescriptions, the orencia offer is on there and so is another biologic med called enbrel (i was on that one 2 yrs ago) but looks like enbrel is offering the same type of savings (6months free copays). biologics are all in the same group together and they are all for different types of autoimmune disorders like the one your daughter has and mine good luck to all of u!! any questions send me a pm,:smile77:

[vintageplumm]

This is awesoem infor Motherofall6 thanks so much !! I had no idea!!

I have automimmune issues aswell...Lupus, Chrons, Rheumatoid Arthritis, ahhh and Sojgren's Syndrome..and they are pretty sure I gots another too but is yet to be identified...My brother too has Anklyoisis Spondalitits, Spell CHeck LMAO

Anywhoo my brother was on Embrel and did fantablous!! He too has Crohns same as myself!

However the whol eoffice visit co pay thing makes total sense aswell. You may very well get outta the prescription cost thru your insurance if u manage to get it billed as part of an office visit KWIM?

Good Luck and God Bless , I cant tell you enough how sorry I am your half to fight this....but I can tell you it's worth fighting and its totally winable !!

[radiated1]

I work at a GI dr office and we administer this drug in our office for patients that are not high risk. It is not billed as routine office visit, but medical not rx insurance. we tell our patients what their part will be before and the sales rep is always pushing us to do their assistance program. they like it to be used. You need to see if she will be allowed to have it done at dr office vs. hospital and let the dr office know that you need help paying for the drugs and they should be able to assist you. if they are not willing to help you with the assistance programs they i would suggest getting a different doctor.......we do everything we can to keep out of pocket cost down for our patients and most dr offices do also......bty...if you have to go to the hospital it will be more expensive but they to have patient advocates to assist you.....good luck...any questions pm me