OMG!!! Cost of Enbrel!

[princesstwinsmom]

Okay, I shouldn't be this surprised, but just got off the phone with my pharmacy - giving them the info on the Enbrel QuickAssist program so they can bill my co-pay. The gal I talked to said the "total adjudicated amount" for the shipment they just sent (three-month supply) is $4,260.27.

YIKES!!! I am so incredibly grateful to have insurance. My co-pay is only $35 and this QuickAssist program will take care of that for the first six months or so. I have a whole new appreciation for people suffering with this illness who don't have insurance to pay for their medications.

[LoriASoCal]

it's scary isn't it. I wonder how many individuals suffer because they just can't find a way to pay for it. I'm very fortunate to have insurance as well. I hear remicade is even more expensive than enbrel, if you can believe that.

[pgerpup]

I'm on Enbrel too, and very thankful for my insurance! My co-pay is also $35.00. So easy to do.


Fay

[ouchyk]

Thankfully, there are programs to help those in need but yeah the stuff is pricey...way out of my reach without insurance.

Keep in mind biologics are also very expensive to develop. The pharmacutical companies need to recoup funds that they paid into development research etc etc...and make a profit, they are in a business just like anyone else...I should get a job working for them lol.

Fay, I love your new picture!

Karen

[mikealex80]

I don't know what I would do without insurance either. My Remicade infusions are almost $7,500 each. Thankfully I have only a $15 co-pay. LOL, Karen are you sure you don't work for one of the drug companys.

[jdeldrid]

You're lucky to get Remicade for a copay. My insurance treats it as a "medical service" -- i.e. 20% copay. So that comes to ~$500 for each infusion after their discount. I have infusions once a month. It's sort of like renting a second apartment.

[Kimbercat]

LOL, Karen are you sure you don't work for one of the drug companys.I think that Karen, like many of us, is just happy to have these drugs as options for those of us that they work for, and that we have decided any possible risks are worth the benefit....a very personal decision.


You're lucky to get Remicade for a copay. My insurance treats it as a "medical service" -- i.e. 20% copay. So that comes to ~$500 for each infusion after their discount. I have infusions once a month. It's sort of like renting a second apartment.You might check with Remicade's manufacturer, Centocor, to see if you qualify for their assistance program. The program isn't just for those without insurance, but also to help people who have a high copay like you do.

The drug companies really aren't the evil entities that some people seem to think they are. Sure they want to make a profit....that's capitalism. But in my opinion, they are also trying to help patients that couldn't otherwise afford their drug. After all, the companies are run by people, who hopefully have some compassion for people that need these drugs. Most of these companies have some sort of assistance programs if you just ask.

[jdeldrid]

You might check with Remicade's manufacturer, Centocor, to see if you qualify for their assistance program.

I bitch about my copay, but honestly, Remicade makes it possible for me to live a completely normal life 27 days out of 28. That's not such a bad deal.

I rather doubt I'd qualify for any assistance -- and even if I did, I think there are people who need it more. It's annoying for us, but not unmanageable. I wouldn't even be worrying about it if I had a freaking job, which I don't at the moment. That plus my former company being purchased has meant I've had to fulfill two out of pocket limits so far this year -- when I land a job, I imagine I'll have to satisfy a third. Such is life.

[mikealex80]

[QUOTE=Kimbercat]I think that Karen, like many of us, is just happy to have these drugs as options for those of us that they work for, and that we have decided any possible risks are worth the benefit....a very personal decision.


QUOTE]
Kim, I agree I was just joking because she sounded almost like a Pharmaceutical rep. I am extremely happy to have the drugs and although I couldn't afford it without insurance, too me it is well worth the costs. I'm 100% clear after just 2 months on Remicade.

[Kimbercat]

I think that Karen, like many of us, is just happy to have these drugs as options for those of us that they work for, and that we have decided any possible risks are worth the benefit....a very personal decision.
Kim, I agree I was just joking because she sounded almost like a Pharmaceutical rep. I am extremely happy to have the drugs and although I couldn't afford it without insurance, too me it is well worth the costs. I'm 100% clear after just 2 months on Remicade.
No problem, mikealex. :) Sorry if I sounded like I was preaching. I knew you were joking. I think some of us do sound like pharm reps when we find something that works for us. I just wish everyone could find the same. :(

And hey, even if you are able to afford a high copay, and feel it's worth the cost, a little assistance never hurt anyone. ;) You could always contribute the difference to the NPF (or me!..lol) if you're anxious to part with the money...lol. :p

[mikealex80]

LOL, Kim I can't afford a high co-pay. Mine is only $15. What I meant was to me Remicade has worked miracles and is worth whatever they want to charge. I even wrote them and told them how great I thought they were. Although I would not be able to afford it without my insurance. I tell my boss she doesn't have to worry about me ever leaving because of the insurance. I agree with you at times I feel like a pharm rep when I share my experience with people. I'm just soo happy to have found something that works for me.

[mammaD]

Hi everyone! I'm new to this board, but not to P or PA. I've had P since my early teens, and was diagnosed with PA aobut 4 years ago. I KNOW I've had it much longer, but I never wanted to admit that in my 20's I had arthritis.

Anyway, for 2 years I used Enbrel. I LOVED it! My coPay was wonderful, like many of you it was $30 a shipment. Well, last year, that all came crashing down. My coPay, with the exact same company, went from $30 a shipment to $480!!! I was able to get one shipment, and haven't had any since. Money is tight, and we just don't have that extra every 6 weeks.

My Doc recomended Remecade, but as someone else said, there is a copay with that too, about $500. Again, just can't do that right now.

I went through the Enbrel assist program, but was told that my prescription company, MEDCO, does not accept it?! Does anyone know if this is true? I've called MEDCO and no one there has any idea of what I am talking about.

I didnt know there was an assistance plan for Remecade. Can I get this on the website?

Within 6 months, we will be able to afford the copays for either, but right now, we can't. I'm having a terrible flare up right now, and I'm ready to sell my house to get something to stop this pain.

I just had to vent, and maybe get some ideas on what I can do.

I'm SOOO glad to have found this group. This is such a frustrating disease, it just makes me want to scream at times!

Thanks everyone, and stay strong!
D

[RichJ]

hi d,
sorry i can't help much but welcome to the p family. you have meet some of the wounderful people on here and will find alot of great info. welcome and nice to meet you.

try and have a good night all

richard

[MikeK]

Hi everyone! I'm new to this board, but not to P or PA. I've had P since my early teens, and was diagnosed with PA aobut 4 years ago. I KNOW I've had it much longer, but I never wanted to admit that in my 20's I had arthritis.

Anyway, for 2 years I used Enbrel. I LOVED it! My coPay was wonderful, like many of you it was $30 a shipment. Well, last year, that all came crashing down. My coPay, with the exact same company, went from $30 a shipment to $480!!! I was able to get one shipment, and haven't had any since. Money is tight, and we just don't have that extra every 6 weeks.

My Doc recomended Remecade, but as someone else said, there is a copay with that too, about $500. Again, just can't do that right now.

I went through the Enbrel assist program, but was told that my prescription company, MEDCO, does not accept it?! Does anyone know if this is true? I've called MEDCO and no one there has any idea of what I am talking about.

I didnt know there was an assistance plan for Remecade. Can I get this on the website?

Within 6 months, we will be able to afford the copays for either, but right now, we can't. I'm having a terrible flare up right now, and I'm ready to sell my house to get something to stop this pain.

I just had to vent, and maybe get some ideas on what I can do.

I'm SOOO glad to have found this group. This is such a frustrating disease, it just makes me want to scream at times!

Thanks everyone, and stay strong!
D

Hi MamaD! Welcome to the Board! Nice to meet you. I'm sorry to hear that you're co-payments have changed to the point that they're preventing you from getting your medications.

Here's the links to two threads that were started by Sue (Beachbound). She was able to significantly reduce her Enbrel related co-payments by contcacting Enbrel's Eliven Services which then made arrangements for her to receive her Enbrel via a mail order pharamacy:

http://www.psoriasis.org/forum/showthread.php?t=11753;

http://www.psoriasis.org/forum/showthread.php?t=11307.

Enbrel has two assistance programs, the ENcourage Foundation (http://www.encouragefoundation.com/) which is discussed in this thread: http://www.psoriasis.org/forum/showthread.php?t=19941 and the QuickAssist program which is discussed in this post: http://www.psoriasis.org/forum/showthread.php?p=307309#post307309. Representatives of both programs should be able to tell you if your insurance company accepts payments from them.

Remicade also has an assistance program and I know at least one person who privately told me that she got assitance from them. Here's their contact information:

Infliximab (Remicade)
Centocor, US REMICADE (infliximab) PATIENT ASSISTANCE PROGRAM
P.O. Box 221709
Charlotte, N.C. 28222-1709
866 489-5957
866 489-5958 (fax)

Source: http://www.rheumatology.org/public/acrast.asp?aud=pat. (You have to scroll down the page.)

I'm going to give you a link to a thread that was started by Leslie ((Momtotwogirls). She took the time to post links and information about some assistance programs that she came across. Here's a link to Leslie's thread: http://www.psoriasis.org/forum/showthread.php?t=12379. I added links and information about programs that people have either told me about or that have been discussed here on the board. (There's even a link to a post by Alyssa Brown, from the NPF's Staff, giving us information about the assistance programs that the NPF knows about: http://www.psoriasis.org/forum/showthread.php?p=260016#post260016.) We don't know very much about most of these programs (some of them say that they provide co-pay assistance), but I can tell you that Jessica (stormechaser) was able to get Remicade for free thanks to a program called www.needymeds.com. (It sounds like a scam site doesn't it?) Miranda (LadyFraser) was able to get assistance for Enbrel, from www.needymeds.com, while her husband was transitioning from being self employed (with no insurance) to working for the government (with excellent benefits). Miranda shared her experience in this thread: http://www.psoriasis.org/forum/showthread.php?t=3979 and Jessica shared her experience in this thread: http://www.psoriasis.org/forum/showthread.php?t=13119&highlight=needymeds.

I hope this helps.

Good luck. Keep us posted. Let us know if you have any other questions and please don't be a stranger.

Mike

[Glennmaroney]

My Remicade is up to a little over $11,000.00 MONTH. My insurance covers all but $30. Thank God! I just had to resign my job because of this wonderful desease. Luckly for me my wife works at the same place I did and they swapped our insurance over into her name no problem. Now if I can just win the lottery to cover my income.. :o)

[docmks]

Yes, it is really horrible to contemplate people not being able to get these medications because of a lack of insurance.

Glen, Sorry to hear about having to resign your job. Will you be applying for disability?

MK

[Tat2U]

The first time I picked up my Enbrel and saw "your insurance saved you $......." I was shocked and angry that people have to suffer because of this price. My sister cannot even use her hands for a good portion of the day, but she cannot afford Enbrel.