Enbrel Insurance related Q's

[vinski203]

I am trying to get started back on Enbrel, needed to change Dr. because of relocation. I also had to pick up my own insurnace which I could only get a $5k a year perscription plan. My dose is 50mg/week, I actually changed that from twice a week upon my request. But I have found out this morning that if I order it as 50/mg twice a week I will get 8 shots for $2071.50 where as if I order 50/mg once a week 4 shots will cost $1288.13. Seems to me I could save about $500 bucks if I get the twice a week dose and only take it once a week. The exp. date is over a year out so it should keep ok.

The other problem I am having has to do with an assistance program I qualifies for and activated. In order to use it I think I have to buy from their pharmacy and the once a week dose (4 shots) cost over $1600...seems strange that it over $300/month more.

My copays are not that bad, $40 through my insurance (after $500 deductable) and $75 through the assistance program. So, my question is what would you do?

Thanks-
Tim

[SCCatman]

Buy it for twice a week, use it once a week.
Rotate your stock, i.e. use the oldest first.
I don't see how you would have any issue with expration dates.
You might want to consider the 25 mgs, you have to take two shots at a time, but they are painless and use a smaller needle, and have none of the preservitive that can cause the 50mg to burn.

The 25mg come as a powder that you mix with the water that comes with it.
Since it is kept dry, it should keep longer than the premixed 50mgs.

Dennis

[heatherf]

The only thing I would caution you on is something that happened to me a while back and I don't even know if an insurance company has the right to do this or not: I am on 25mg twice per week and I admittedly skip a dose here or there out of forgetfulness and/or laziness sometimes. When Caremark Pharmacy called to remind me of my refill being due and I said I didn't need it for a couple of weeks the woman actually asked me if I was taking the drug properly and if I was complying with my doctors orders! I fibbed and said I had gotten behind because of not feeling well and I got my meds but I always wondered if I could be denied later because of "noncompliance". Since then I do try to keep up with the schedule better but if it's time to get my monthly supply and I still have a dose or two left I just say ok, send me my order!!! I've been clear for over two years and have always wondered if I could maintain with one shot a week instead of two and only pay the copay every other month but I'm scared someone will take my precious E from me.

[jaken]

heatherf, you've been on two shots of enbrel for two years? i thought that you only take two shots for the first three months and then switch to one shot a week.

If i didn't have insurance through my work i wouldn't take enbrel. I think that its too risky to take enbrel if you're not fully covered. The chance of a hospital visit is greatly increased by taking enbrel.

[heatherf]

Two 25mg shots, which is the old Protocol for PA back before Enbrel was approved for P. Even though I could go down to one shot a week, changing to the 50mg once per week would be the same amount of meds and since everyone was complaining about how much the 50's hurt I decided to stay with what I'm doing!