whew nothing like the leaving the patient out of the whole picture

it's not like they are substituting a generic for a name brand.

do they both block TNF the same way?

did you have the patient co pay assistance program in place for humira when this switch and run was done?

does simponi have the same programs for co pay assistance as humira, enbrel and orencia?

more paperwork for you and they didn't even call you to tell you.

wow.

hang in there

Ros

Just looked it up. (I'm doing biologic research today anyway.) Looks like it IS a TNF blocker, like Humira and Enbrel, taken by injection once a month.

http://arthritis.about.com/od/brms/a/TNFalphablocker.htm

Here's a handy little page with a bit of compare & contrast. I'd be pissed, too. I've never been good at taking orders or doing what I was told with no questions.

As far as insurance companies getting to decide, it's nuts. It's not like there is any national protocol, where first you try A, then B, then C. It all seems to be predicated on who's sleep- excuse me, golfing- with whom.

Thanks for the research info, alto. To answer some of ros' questions, I do have the Humira program and card in place as they told me to register that day.

I completed my portion of the paperwork needed to get assistance through a different program via NeedyMeds.com (org?) which a friend of mine was able to get approved for her daughter after their insurance company also decline Humira until they tried a gauntlet of meds.

I am going to pop into the Rheumy office tomorrow with my completed papers, proof of income, insurance cards, etc. and hold firm to having my dr. fill out the physician paper and submit it ASAP.

We'll see what happens.... Fingers crossed!

There are 5 TNF blockers - Enbrel. Humira, Cimzia, Simponi and Remicade.

Google: www.simponi.com - the official website where it states that Simponi is used for Psoriatic Arthritis and there is.a patient help
scheme similar to Enbrel and Orencia.. Simponi is a self-injection once a month after the first two loading doses.

I'd be thinking about a new Rheumy who works with you (not agin you) and keeps you in the loop.

There is a very different Health System here (Australia) - no such thing as medical insurance attached to employment, thank goodness. I'm sure I couldn't handle the Insurance Company telling me what meds I have to take. Surely, that is why Specialists have to do so many years of study.
I'd be pissed off, too. One thing I have learnt is that you are your own best advocate and have to stand up for yourself
Good luck

Oops, just disregard the comment about Psoriatic Arthritis. Got your post and alto's post mixed up in my head. Brain fog!!!

I was on the Humira patient assistance program directly through Abbvie the drug manufacturer. It wasn't a hassle at all. Just submitted a single page application and my Dr had an almost identical form which included the actual rx info like dosage & number of months. When it runs out they contact your dr directly for a new rx. Had to attach last years tax return and was approved in about 2wks. I could snail mail, email, or fax it to them. They called when they received everything and again when it was approved to schedule delivery thru Express Scripts. The income level cut off was $175k for tax yr 2012. So unless you make more than that there shouldn't be a problem getting approved.

I didn't go thru needymeds just the company. I also didn't have insurance. There is no co-pay at all with Abbvie. They send you three months/6 doses at a time for free. Didn't even pay shipping. The biggest hassle is someone over 18 has to be home to sign for it on a weekday from Fed Ex because its refrigerated (comes in a big styrofoam cooler) & the cost factor probably matters too. 3mo is roughly $10k worth of meds. But they give you a window of a few hours of when it will arrive. When you need a refill you just call the 800# on the rx like a regular pharmacy and they will call to confirm your delivery date & time. Honestly one of the easiest companies I've worked with. Only dealt with Express Scripts automated system which was lucky after some of the stories I've heard about them lately.

Dispute that credit card charge if you can and go directly thru the company. I doubt you can return medicine once you receive it. Your Dr should have the form/application. The drug reps give them out in a notebook that they just tear off a page. The nurse can fill it out and the Dr just needs to fill in the script info & sign it.

Good luck. I'm sorry you had to pay anyone anything only to find out you're not even getting the med you need. Even if you have insurance & your insurance denies Humira you can still use the program. They will call hour insurance company to verify the denial.

Emerald

Emerald,

Thanks for sharing your details. I got the Abbvie forms through the NeedyMeds website. Everything was faxed in yesterday afternoon, so I'm just waiting to hear back...

Fingers crossed!!!

whew nothing like the leaving the patient out of the whole picture (Ros). You see this is how these insurance companies are. No one could call and say your doctor ordered X, but we have to start you off with Y first. The insurance companies are looking at it monetary wise though most of these biologics cost about the same when you stack them up. Good for altoclef for jumping on that right away and looking up the information. Will have to look up that link. I tell you, you guys are great. There is a lot of comradery here. Good luck with the Simponi if that is what you end up with. Hope it helps you.