NeedyMeds offers a drug discount card good for 80% off prescriptions at participating pharmacies.The Patient Advocate Foundation has a co-pay relief program that covers any medication for a particular condition.The Good Days organization helps pay for your out-of-pocket costs for Cimzia, Humira, or Remicade.There's a long list of organizations that might help you cover the costs of your RA medication. “Usually if you are looking at one of these programs, you are not on Medicaid already.” “These are usually paper-based programs with longer application-processing times,” Donovan says. Often, these programs are for the elderly or people without a drug plan. These may help pay your insurance premiums or drug copays. The federal government's Medicare website has a page where you can check whether your state has a PAP. Your doctor’s office will need to validate your RA diagnosis and biologic prescription. With most PAPs, you need to provide lots of information about your medical history. “The more comparative information you get, the better off you are,” he says.Īlso, “expect a lot of red tape,” Donovan says. If that's not your preferred biologic, he thinks it’s a good idea to compare your costs using the PAP with those of taking a conventional DMARD. Remember that a company's PAP will only help you with that manufacturer’s drug, Lexchin says. You can search online for assistance programs offered by makers of arthritis medication. They might even reimburse you for transportation to an infusion center. For others, they might cover all co-pays for a few months and a portion of them after that. #RINVOQ COPAY CARD FREE#These may offer a biologic free to low-income people. You have more options to research:ĭrug manufacturers’ patient assistance programs (PAPs). Maybe even after you negotiate with your insurance company and work with your doctor, it’s still hard to afford your biologic. “The list price gap might be as low as 10%-15% or as high as 40%-50%.” Assistance Programs and Discounts “It’s not clear why that is, and it all depends on the drug,” says Joel Lexchin, MD, of the York University School of Health Policy and Management. The FDA has approved the biosimilars infliximab-axxq (Avsola), infliximab-dyyb (Inflectra), and infliximab-abda (Renflexis) to treat RA.īut bear in mind that their price advantage over biologics isn't always a big one. They're made from the same sources, with the same benefits, strength, and dosage. Or they might have free samples of medication on hand that will save you money for a while.īiosimilar medications are another cost-saving alternative to discuss with your doctor. “Your doctor will be happy to talk about whether the advantages of the best option for the patient are worth the cost, before kicking it over to the insurance company.”įor example, your doctor may be able to prescribe a less expensive biologic or a conventional DMARD that will give you relief from inflammation and pain. “I hope nobody feels reluctant anymore about having this discussion,” says Nancy Carteron, MD, a rheumatologist with the University of California-Berkeley and a director at the HealthWell Foundation. Your doctor can be an asset in making your RA medication more affordable. #RINVOQ COPAY CARD PLUS#The Patient Advocate Foundation offers free online templates for appeal letters, plus guidance on the process. “Hopefully, your doctor’s billing office can also help you with an appeal.” “While appeals can be a huge pain because it’s almost a legal argument, we always recommend going through the process,” Donovan says. You can file an appeal with the insurance company if it won’t authorize coverage or denies your claim, says Caitlin Donovan, senior director of public relations with both the National Patient Advocate Foundation and the Patient Advocate Foundation. If your insurer doesn’t want to cover the biologic your doctor recommends, that doesn't have to be the end of the story. Even with Medicare Part D, one study estimated annual out-of-pocket costs for RA biologics at $4,800 or more.
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