To start with, doctors often recommend what they are most familiar with, and what they have seen the best results from.

I'm pretty sure Orencia was originally available only as infusion. As an IV, it's probably absorbed more quickly and completely and utilized easier. Ros has said that it is slow to work, and the IVs may speed that up some. The home injections are simpler for many people, but not those who are terrified of the DIY process. Making the monthly trip in for the infusion is time-consuming, and a bad deal if your doctor's office is a major drive.

With insurance, the injections fall under the drug coverage of your policy, where as the infusions are considered major medical. Some folks do better one way than the other financially.

Call your doctor's office and see what they think.

Thanks. I'll check with the Dr next month to see if I can make the change. For me, insurance covers the infusion at 90%, but prescriptions $15. It would be less time consuming as well.

Hi Melissa

sometimes the doctors just don't think of the financial situation. in my rheumie office it is the administrator who does the thinking and interface.

for me, the infusions would be thousands a dollars per year in uncovered costs. Unless i happen to waltz in with my deductible and coninsurance paid in full by other services for the year. Which is the case now.

The shots, if approved on the orencia co pay assistance program, are billable at $5 per month for a box of 4 shots every 4 weeks to your home. $60 per YEAR.

I also have a huge deductible and 90 percent coverage which does not convert to 100 percent until thousands of dollars co pay.

so for me it was a financial decision, at first.

this year after my neck surgery I have had the co insurance and deductible satisfied so my rheumatologist has suggested that upon re-entry I use infusion.

then to my surprise she sends me orencia co pay assistance infusion papers? I think WHAT are these? I thought co-pay assistance was applicable ONLY to at home shots.

I filled them out again, attached a tax return, w-2 and latest pay stub and off they went back. I have no idea what they are. I have to call on Monday and I'll let you all know.

perhaps I will NOT have to switch back to shots January 1, 2015 which is my plan since I can not afford the uncovered costs in infusion at the start of next year.

I assume you are under 65 and on an employer group health plan.

as to convenience and time, I think it is every bit as important to bring up that you rather shoot up at work or around the kids, family, commute and work schedule with the self injection needles.

i just happend to ask the rheumie about one versus other. she said sometimes people respond better to the infusion, but not necessarily so. She also said it loads quicker. and She also said for her IV patients each monthly dose is exactly calibrated to their weight.

BUT if you need the money for the kids and family and you want to try and see if you can get the same response with the needles, I would ask her if you could switch.

I can't see how if could NOT be cheaper than what you are paying 10 percent cost wise on the infusion costs now (versus either a third tier co pay like $35 or the orencia co pay program of $5)

I am desperate for relief after an infection/surgical hiatus otherwise I would insist on needles only at home when I re-start. I can think of better things to do than sit in an infusion office, provided, the same responses are similar.

But since we are all different in our RA, only you will know. You could always switch to shots. watch for the response and then switch back to infusion.

ros

I have never done an infusion, but am using Orencia injections. It is very easy. I give the shot in my stomach - which sounds terrible, but barely hurts. If I did the infusion, I would be driving almost 4 hours round trip, and in the winter it might be bad driving conditions. Like Ros, I pay $5 per month. The injections are delivered right to the house. Initially, it was a little scarey to give the shot.

Melissa, if I remember rightly, you are teaching overseas. I had to get blood work done 5 days before each infusion so that the hospital could check it out with the hospital Rheumatologist If there were any signs of infection at all, the infusion could not be done.(Australia)
As I have been getting 4 weekly blood tests all the time I've been on MTX, I tie them together.