Biologics, Part 2

Having figured out that part of my reluctance to take a BRM (read part 1 here) is that I don’t want to need one, I’ve dealt with that.  I will not let irrational fear prevent me from getting the treatment I need.  Especially after such an outpouring of support.  Thank you again to those who commented and emailed.

Reason number two.  Stupidest reason of all:  I failed.

Biologics are for people who fail  DMARDs.  How can you fail a drug?  I’ve never failed anything!

 Go ahead.  Laugh.  I did.  This is probably the silliest thing you’ve ever heard!

(I really do think that different nomenclature might help.)

***

Biologics, Part 3

This is the third in a series.  If it makes no sense on its own, start with part 1.

A portion of my reluctance to take a BRM  is the cost.  Yes, economics finally rears its head.

Everyone talks about how incredibly expensive biologics are – even people with good insurance.  I’ve heard people talk of a monthly copay of $300 to $800 for a single medication.  That money has to come from somewhere. 

I try to minimize the impact of RA on my family.  If we have to cut back on the food/clothing/education/entertainment budgets to pay for medicine, that makes it pretty difficult to ignore the economic impact of this disease.

I have a child headed to college in two years ($30K per year for five years at his school of choice).  Another the following year.  Another kid the year after that.  The year the oldest finishes school, the fourth begins.  The year the third child finishes college, the youngest begins.  Money is going to be tight.  I’m happy to scrimp for my kids to get a good education and go chase their dreams.  I’m not so happy to have the family do without things on my behalf.  Who needs the government to ration care when I can ration it all by myself?

How to explain this?  Many people have mentioned programs that the pharmaceutical companies have to help people with their co-pay toward biologics.  Great.  My rheumy even mentioned it – maybe she thought that was my hesitation.  The thing is… our income makes it unlikely that our family would qualify for any assistance.  Someone with no money might qualify for help, but I wouldn’t.  And I don’t have hundreds of extra dollars sitting around.

The more I’ve thought about this situation, this is the easiest problem to address.  What if I’m worried about nothing?  My insurance is pretty good.  Usually.  Maybe these won’t be as expensive as I’m afraid they’ll be.

Lots of research to do…

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5 thoughts on “Biologics, Part 2

  1. The Enliven Program (Enbrel) will help you regardless of income (for up to a year) — as long as you have commercial health insurance. Enliven accepts the amount they would take from the insurance company but decreases the amount of your copayment. Given that you have insurance, my guess is that you’ll be eligible right away. Your RD should be able to tell you that. I’m not sure about other BRMs, but pharma pretty much has a program for every BRM.

    There were two things that scared me about BRMs and going on them: First, to me, that sort of treatment meant that my RA was serious enough to warrant that sort of treatment. I mean, only people with serious RA go on BRMs, right?

    Second, I was, just plain and simple, scared to death of the side effects, which I investigated and re-investigated. Talk about a major downer! My RD talked me through it, however, and I was able to start Enbrel. Of course, the ironic thing is that I had far worse side effects with the MTX and leflunomide (Arava) than I’ve had with the Enbrel.

    Now, I look back and wish I’d started Enbrel earlier. Sometimes too much knowledge is a dangerous thing.

  2. I absolutely abhore the semantics used by the medical and pharamceutical industries in regard to a drug’s usefulness in an individual. Why in the world do they say that we “failed” the drug when, in reality, it was the drug that failed us? This irritates me no end. So I “failed” MTX. Along with the fact it made me feel like I was slowly dying, it had absolutely no effect on the RA. How is it that I’m the one to blame, here?

    I hope you can just breeze on past that silly “F”, WarmSocks. Having to move on to a biologic med isn’t your failure, it’s the doctor’s and the drug’s. So there.

    That said, I hope you can get some help with the outrageous costs of taking this new med. Can’t blame you for being reluctant, given the needs of your family, but it’s possible that the costs if you don’t switch to the stronger drug will be much higher still in terms of disability, surgery, etc.

    Sending you hugs, courage and calm. Be gentle with yourself.

  3. I think you do a great job here in expressing the problem with the use of the word “failed” regarding medical treatments that don’t work out as well as envisioned. I tried to suggest to Abel Pharmboy that he read this also. I think it is an important message.

    Best wishes to you and your family.

  4. Pingback: Patient Assistance « ∞ itis

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