Sorry you're having a rough time. How long have you been getting Rituxan infusions? My experience was a slow initial response, but I started getting some benefit in the third month of my first treatment set, had 2 wonderful months, then a bad 6th month. After 7 weeks in my 2nd set of infusions, things clicked, like a switch was turned on, and the rest of 9 years has been great. I ask because I've heard of lots of doctors switching people because the drugs haven't worked quickly, but that's obviously between you and your doctor. If you've been on Rituxan for a while, and your doctor wants you to switch, I assume he/she must feel it won't work.

Do you know what pain is directly related to RA and what might be caused by OA?

Good luck. BTW, one of the good things about Rituxan is that it's generally (always?) considered a hospital procedure. My infusions have been. That means that it's not considered a drug and is generally fully covered. If it doesn't work, doesn't matter.

first off I am sorry for these challenges. You sound like you are thinking about a change.

what do you think about maybe writing a letter of financial hardship for your pre-existing financial balance and negotiating a lower payment plan for the life of the balance?

From trying so many I have come to learn that many biologics including say for example, orencia can be aministered as budhha states "a hospital procedure" as well as enbrel and as well as humira and as well as actemra....

My rheumatologist can also sometimes administer as an infusion in her office.

could you ask office staff to put through some dummy pre-authorization claims?

Sometimes going online to one's medicare part D online portal and researching part D (prescription drug carrier insurance) drug schedules to see what one's co-pays are for self injection, can be helpful. Remicaide is not the only biologic covered under some Medicare Part D carriers in the united states.

as I recall, co-pay assistance plans with the pharmaceutical companies apply only to commercial insurance and not to government plans.

In your rheumatologist's do you think there is a billing manager who could run some pre-authorizations for you after you talk options with your doctor?

Medication management is different for all of us on our individual RA journey.

for my anecdotal two cents, I limp badly, also. I have not found the novacaine patches effective - so I don't use them. i understand and empathize with your pain. I am the recipient of frequent lung infections, that are worse when I am on a string of months of my biologics and dmards. So I am frequently interrupted throughout the year while trying to clear a lung infection. I know I should think about damage, but I try to think about my life in function. I am still living alone, so I guess I am making it. My RF factor has increased during this game of lung roulette. and so has the erosions on my MRI's. I wish my walking would get better instead of worse but that just ties into my current state of function as relates to my medication treatment.

I can not take rituxan due to my lungs. I am glad that it works for Buddha and that you sistah currently giving it a go.

how's your function? co-morbidities? do you like physical therapy? I like the hot water pool.

depot

Hello all. I am new to this Forum so I thought I should start at the beginning.
I am Scottish and live about 7 miles NE of Glasgow.
We have excellent Free Healthcare and excellent modern hospitals and Specialists.
I have RA and also developed Rheumatoid Vasculitis.
My RA started overnight about three (3) years ago at ave 66.
I went to bed feeling great one night and next morning I couldn't move for pain
It turned out, I had Polymyalgiarheumatica.
A large dose of Prednisilone (28mg daily) sorted me out in two to three days.
A month later after loads of tests, x rays and blood samples, I was told I had RA.
I was quickly put on Methotrexate (20 mg/week) and other drugs.
None made any real difference.
I was then started on Etanercept (Embril) and it was great. Unfortunateky, it triggered off Vasculitis which resulted in a huge and deeo ankle ulcer on my right foot (5" x 2") and you could see my Achilles Tendon I was Hospitalised for a few weeks where they put me on a very high dose of Prednisilons (65 mg/day) They also started putting on a Seaweed dressing.
Now, 2 1/2 years later it has all but cleared up. The high dosage of Prednisilone went for my Cataracts and they have now been replaced.
Today; I an on 20mg a week of Methotrexate and I get 6 monthly infusions of Rituximab (Mab Theera).
Pain is very well controlled but, although mainly healed, my feet still give me pain. I walk with the aid of a walking stick.
Sorry this is so long but I thought the History was important.
Thank God for our NHS !!!

eddie

I am glad you got relief.

I hope sistah is encouraged by your story. I know I am. You get the rituxan every other 2 months?

I am glad that you national health insurance in Scotland has been holding you up.

depot

I want to thank y'all for some good things to ponder. I am having a difficult time typing which is very new for me. So many joints are involved right now all at once. Everything is bilateral and hot and full of fluid. The scans that I have had are having all my docs stating that RA is a raging forest fire right now throughout. I know I also have some OA for a lot of areas are bone on bone and there's just no cushion left yet the synovial fluid is full and painful.

My Rituxan Infusions are given to me in the "infusion room" at the medical center my rheumatologist is at. One area is just for biologics and I can talk with others with auto-immune diseases needing infusions. I'm thankful it is a medical procedure so it's covered 80%. I get them (a set of two infusions) every 6 months. That is the reason we also tried Remicade since it was covered under procedures but even at 80% I still owed thousands for the year and half on them.

@Eddieboy- Thank you for your story. I'm so glad you chimed in on your experiences, it makes me feel so much less alone. Thank you everyone for your comments. I had to take two pain pills tonight just to be able to get on the computer and type. I am limited to 4 or less per day so I save the pills for the evening so I can sleep some and catch up on typing. I take one in the morning, one before I do an errand and two at night.

I appreciate all of you. -Donna

P.S. I will figure out how to talk to my doctors and hospital about working on my high bills. The thing is I owe so many people that a lot of times I have to just toss the bills aside and only concentrate on the most relevant at the time but it's starting to bitr me in the butt because those that I haven't been able to make a payment on are the doctors I am needing now. :-(