Tysabri - once a month IV infusion...but its not a first line drug. I think you would be described as a "under insured person" and ma qualify for patient assitance programs because of it. Call copaxone shared solutions and see what they have avauilable. Rebif has a program that the first year of use will not cost over a certain amount and I used betaseron on a PA covered fully except for the mailing cost because I had no inasurance.

I have read of that avonnex 1x per week shot being covered under medical if done at the dr office, but thatr was people planning it, I haven't read of anyone actually getting that done ...perhaps someone has experience...

Its just time for you to start using the phone. Start with shared solution they may know of how to get around BCBS or may have a program for underinsured or first year underinsured?

And remember there is always ldn to go to which I think works better in some places than others...

It takes 9 months for copaxone to reach full effectiveness, so it was a good thing you put a hold on it & refused to accept it if you were not willing to do 9 ($18,000) months with it.

Paying for 1 month out of savings while you tried to resolve the situation more permanently would not have been the optimal decision on your part.

Once its accepted and in your possession,it can't be sent back, it can't even be given away. Its a frustrating thing you can go back and read posts, when someone switches a med, they can't even give the unused old med away. Can't mail it to someone who might need it-its illegal to mail meds if your not a pharmaceutical distributor..

We all know how expensive this meds are & would like to give the unused stuff to someone who needs it. We can't do it, we can't even give it to the doc to give it to someone else who needs it. Once its in your possession,, it's yours and can only be used or thrown out :(

So it was a very good thing you didn't accept that copaxone--that was a close situation you avoided!

The fact that they were shots was the second reason I decided to go without meds...the first being that supposedly I've had this illness for 25 years and have gotten by without it. But I just checked with my insurance company yesterday and while I do have a 2500.00 deductible, it would cost me over 3000.00 per month for the copaxone if I didn't have insurance. That is way too much money for still having a 40 - 80% chance of having a flare, and not having any protection at all from a catastrophic flare (this info from my neuro). I'll stick with Vitamin D and fish oil. It's about as effective as the meds and it costs a lot less money.

I refused a med for 8 months, tried ldn during that time and got very much worse....but actually it was nice to have more certainty that I needed a med. After that 8 months I was without uncertainty. And I had a had a stronger case for SSDI.

I did fish oil at that time too. I was throwing everything but the kitchen sink and MS meds at my MS. ;)
It might have been a valuable time- for gaining certainty that I need a MS med.

I wish that certainty would have remained or I could go off a med periodically to see if I still need it?


You see past posts on that subject too, as I'm not the only one who feels like that at times.

Contact the drug company to get help on how to get your insurance to cover. They may also offer financial assistance. Go on line and see if there web site will clue you in on how to handle your problem.

Good luck!

NMSS site with links to all the ms meds and their help lines

http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/index.aspx

Check resourses on this page like NORD for underinsured or the chronic disease fund.

http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_eng=Multiple%20Sclerosis

..." http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_eng=Multiple%20Sclerosis

..." http://www.needymeds.org/copay_diseases.taf?_function=summary&disease_eng=Multiple%20Sclerosis "...

Just multiple versions of same link, sometimes a link posted 1 way will not work but if posted a different way it will? I just post multilpe versions of long links.

Tyhe first of generic meds(biosimilar) drugs for MS should be out next year--already the nmss lists.'Extavia" the generic for betaseron. The generics are only likely to be about 20% lower than the brand name drugs, but perhaps insurance will cover them diffeently?

Actually on the nmss page it says approval has already been given to market?

Just curious, did your doc give you a pamphlet on that on too? or just the crab drugs? We are in a transitianal time with these meds.

I think avonnex done once a week at dr office is not covered under medical because the majority use is done at home as a sel-injectable and if a person does not have a reason for being unable to self inject-like their hands don't work--its denied as a medical covered expense & remains pharmescuetical. So i don't think that was a way you could have gone or anyone has gone.

I know someone whose cognitive functions have decrreased so much that a nurse comes once a week to give him his avvonex shot. But he's on medicare. That would be another reason, besides hands not working, that a person would not be able to give themselve a drug that aaprove,marketed and sold as a self-injectable med..

With my insurance, any injectable is covered under the medical benefit, not the Rx.
The same is true for chemo patients -- covered if it's injected/infused, but not oral therapy.

So DO check with your insurance provider re your coverage -- it varies by the insurer.

And I think Copaxone financial help has a reputation for being very generous, so do contact Shared Solutions.

Does your coverage have an out of pocket maximum per year? Check to see if this will fall under that category. That's how I had Copaxone and Avonex covered when I tried them. At first we didn't think we could afford Copaxone since they told us the same thing... huge copay. My husband spoke at length with the insurance company and they said it could fall under the out of pocket maximum which is $2000/year. I ended up not staying on either one since I couldn't tolerate them, and am now on Tysabri.

But the out of pocket max is something to ask about anyway.

Hmmm this is interesting. I have horrible insurance and I just called Shared Solution on Monday and they are fighting it out with my insurance company now. I dont know what will happen but when I told Shared Solutions about my insurance they told me not to worry and that they would find some financial help for my Copaxone. We shall see, I for one dont have very much faith in the "medical Community" I may end up just doing the naturual route until SSID kicks in and even that is not a for sure thing yett. Good Luck to you

when I read stuff like this I am so glad I'm Australian. I pay $5.40 a month for Avonex, because I have a health concession card. The government does good things for people with their medicine.