Just through the drug company patience assistance program. I received Humira through them for 10mo.

But I know Humira and Enbrel are both used for dx other than RA. I didn't realize Orencia wasn't. But it must be or your Dr wouldn't have written it for you right? Have you already tried Enbrel?

Someone on a FB forum today said her co pay for Orencia was $800. That's ridiculous. Who can afford to pay that? As much as these bios cost they should come with a nurse to administer the damn shot.

I'm am diagnose with UCTD I also got the copay card when they asked it I had RA I said yes I asked my Doctor about it and he said if was fine I used it a few times but orencia made me tired I am now on Actemra.

if the orencia co-pay people had pushed it thought for you Orencia would have paid your ENTIRE co-pay up to 12 times per year maximum of $4,000 of the uncovered copay with you paying only $5.00 per month

so yeah, you needed that copay assistance program to go through........

i had a problem with them also at first. Massachusetts used to have a prohibition in place for co pay programs right around when I went onto orencia but our state house passed a bill with an immediate effective date to over turn that legislation and make co pay programs legal shortly before I enrolled.

what i like to call "the voice on the phone" couldn't get that i knew the bill, had written and called my state senator and that no their website interface program for enrollment was wrong.

so maybe at Orencia could tell your doctor why ONLY RA is a supported diagnosis for co-pay assistance?

part of me would like you to have your MD return a dual diagnosis with RA on it to just get this ball rolling

the voice on the phone has a script, he is just reading stop/go questions and then they hit a wall and can't troubleshoot.

can you google this query and see if anyone else had this issue with diagnosis? not sure whey they are only supporting one type of auto immune dx

Ros

orencia is only used to treat ra; treatment for psa may be a common off-label usage, but it's not noted on their website. if the person on the phone hinted at calling back and speaking to someone else, i'd think that means that they aren't going to come back at you if you don't have ra and try to recoup the monies.

having said that, i believe pharmacies will see icd9 codes, so they could determine the diagnosis. it may be worth a call to your doctor to see if they can 'add' ra to your diagnosis, just to cover everyone's butts.

I struggle with the same thing altoclef - I'm too honest - to the point that is what actually cost me loosing my Humira for the past 2 months.

I was approved for free Humira from the Abvie Foundation through this coming May. When I procured insurance last November, I told my doc that I was going to stop the free stuff from the foundation and to please start the pre-authorization process for Humia (which at the time was on their formulary list). Now because of the blunders of my doc's office, I never received it through the insurance.

Tough call weather to call back and say "yes" to if you have RA. A decision like that would keep my up at night thinking weather I should do it or not.........

That's senseless. If the med treats your form of arthritis then what does it matter? Obviously it's approved to treat yours or the doctor would not have prescribed.
The new mail order pharmacy gave me a few numbers to call for assistance with Orencia. I'd be happy to try to locate those for you.

As to what to say with a second call, that's a hard one.
Your doctors office gave you the card so maybe put a call into them & let them know the problem your having. They may recommend a way to deal with it.
With the cost of these meds I don't get why it has to be so difficult.
If I can help please let me know.
Good luck, Sammy

Thanks for all the replies.

Orencia i currently only approved for RA, and I'm not sure that will change. After hurting my brain with too much computer, too many technical articles, it looks like it did well in trials for psoriatic joint involvement, but kind of, shall we say, sucked at clearing skin. Many PsA patients have heavy skin involvement, so the suckage there is a deal-breaker. Makes it not worth the time and money to win approval.

I emailed my doc about this through the patient portal. Any communication there is part of my records. She, naturally, said she couldn't advise me to call them back and have a different answer ready. She's a bit hard to read in person, harder in writing, so I'm not sure what she thinks. With her income, she most likely doesn't understand the limits of mine.

PsA was only fairly recently split off from RA- maybe 40 years ago. Within my lifetime.

Sammy, if you do still have those numbers, please pass them on.

Ok these are numbers Accredo gave to me
Help wealth foundation
1-800-675-8416

Trial card
1-866-962-1128

Patient Advacate
1-866-512-3861
Now I never called any of the above. Via Jen I googled for Orencia's
Number & applied through the co pay program.
You know these meds are so darn expensive you may want to try giving the RA diagnosis.
It's not as though your taking $$, your simply wanting help the same as the rest of us.
I'm thinking there are those doctors that don't realize the cost to patients.
I hope these things change & if a drug is prescribed & helps it gets the same consideration with financial help.
Hope you can find the help you need. Good luck
Sammy

Sorry via Ros. Anyway let us know

I just got a call from my insurance company. They have approved the prescription- I was a bit concerned about that, as it's off-label for my use.

When would you like it shipped? Where to? Any questions? Need any supplies? Oh, by the way, we applied for a co-pay card for you, so it will be $5. Sure, we can bill you for that. Problem solved.

I'm a little concerned about this new (to me) insurance company. They answer the phone promptly, they talk to you nicely, they know what they are doing. Their benefits are great, and nothing is a problem for them. My old one spent so much time trying to make my life difficult, rejecting claims, etc., this just doesn't feel right!

It might not feel right but I would say go for it... finally someone is out there to help you and not give you a hard time... about time!!!! That is wonderful!!! Glad it is going through for you!!!

It's so nice to hear a good story about insurance.

I'm going through such a battle right now with all this - lost my Humira for 3 months now and counting all because of incompetence and mis-communication between my doctors office and insurance company.

I must say that my insurance company has been great like you said in your post - very nice and polite and have never been put on hold when I call. I've finally narrowed down the bottle neck with this problem and it turns out to be the office staff and my doctors office.

So don't be concerned - just be happy you now have an insurance company that is working with you - congratulations!

oh that's just alto's brand of facetiousness that we love. i love her irreverence. keep it up. orenica ships on ice practically overnight when it is released. start rolling up your sleeve.

congratulations :)

Ros

Well thanks be to god.
Alls well that ends well.
I just started Orencia last week, injection due today.
Let me know how it's working for you.
Here's to success!
Sammy