insurance wont cover new enbrel injectors

[sporkster]

our insurance wont cover the new pen injectors for enbrel for my dad. without insurance they cost $3000 for a one month supply. they pay for the normal injections only. is there anything we can do?

[jdeldrid]

I don't mean to sound like a complete b**ch, but the alternative is to learn how to do the shots. It's a really tiny needle, and even shot-phobic me has been able to deal. Really, if Enbrel works for your dad, the shots are worth it. They're easy, and as long as you let the Enbrel come to room temp, they don't hurt. It might sting a little, but it's no big deal. His doctor will set up a time to give him (or anyone else he wants to do the shots for him) instructions. The nurse who taught me was even willing to let me practice with syringes full of saline if I wanted to (I didn't).

-- Jaye.

[sporkster]

I don't mean to sound like a complete b**ch

dont worry, you dont. he's been using the normal injections for a while but weve heard that the new kind is easier and less painful.

[Kimbercat]

You can try calling the patient advocacy dept at the NPF. Sometimes they are able to help with insurance company problems. Good luck, and I hope your dad can get the new ones.

[SCCatman]

Iwonder why the high price, that is twice the cost, or about 1,200 for the injector.
Maybe that is for the first three months, where you do 50mg twice a week?
It often takes some time for insurance to add a new version of a product to their fomulary.
Where did you hear they would not be covered?
I would not panic yet, as this may change.
Dennis

[Allie]

It often takes some time for insurance to add a new version of a product to their fomulary.

Dennis
Exactly my thoughts... If you Dad can keep using the shots a little longer, I am pretty sure within the next few months insurance will approve them.

[tonka42100]

I agree with the last 2 posts! You probably don't remember or know about it,but when the insulin pens came out no ins co would cover those either.Now,they pretty much all cover them. It normally takes from 1-4 months before you start seeing coverage for new items. I work in a pharmacy and the only ins I have seen so far that covers the auto inj right now is tri care. (that's the ins for military personel and their dependents if you didn't know) My own ins co doesn't expect it to be on their formulary for about 6 months.
I would suggest your dad give it a few months and then call his ins plan again and find out if it is a covered item.
Good luck!

[sporkster]

thanks guys!