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Journey through biologics now stelara

Started on Humira 8 years ago, every 2 weeks. Worked for 3 years then it was losing its efficacy. Was put in every week, in other words increase its frequency. Went another year and it was not working. Humira is an anti-TNF drug so needed a new approach.

Was put on Entyvio for 1 year. It is a different approach: it binds to integrin and blocks cell communication for inflammatory activity in the gut. It is said that Entyvio takes many months to take effect. After 9 months I saw no changes at all, it is my belief that by then there should be SOME improvement and there was none.

Was put on Remicade and Azatiopine to prevent rejection of Remicade. Remicade is another anti_TNF inhibitor. Worked for a year, then was losing its efficacy. Was doubled in the dose, a year later it was losing efficacy again. This was the second strategy, increase VOLUME. The first was on Humira with FREQUENCY.

By then Stelara was on the market for Crohns, Had the infusion in January and responded very well. I am on the first injection. The problem with Stelara is its unbelievable cost: In California it retails for $22,000 per injection. Did not qualify for the copay assistance program because, even though I was on Medicare they counted my withdrawals from investments + my wifes income. With Medicare I had to pay $3480 for the first injection and $1200 for each injection there after. I am trying to get approved for the injections being given at a medicare approved doctors office which brings a substantial discount.

Stelara is another approach which blocks proteins Interlukin 12 and 23, very different than the others.

With these prices, Stelara will not be the first choice for anyone starting on Bologics. My opinion is that Humira is a better starting point, if it doesn't work, then Entyvio is a better second choice, it has worked for others and it is less expensive.

Remicade has been around for at least 15 years, so it is likely that the $15,000 per infusion for the initial R&D cost has already been recouped. I don't see its price being brought down.

If anyone has succeeded with other financial approaches to Stelara it will be greatly appreciated.
 

my little penguin

Moderator
Staff member
With Medicare isn’t there a catastrophic out of pocket each year ?
I’d you speak directly with Janssen?
There isn’t an income requirement on the
you use Medicaid, Medicare, or other insurance and still cannot afford STELARA®, we can provide information on affordability programs or direct you to independent foundations that may be able to help you. To learn more, call a Care Coordinator at 877-CarePath (877-227-3728).

From
https://www.stelarainfo.com/stelara-cost-insurance-information

Typically Crohns can sometimes can qualify for Medicaid as a disability
Which is different from Medicare
Under the federal blue book for social security disability
Crohns is listed
Might be worth a look
Takes forever to get ssdi
But ....
My kiddo is under 18 and on Stelara so different situation
Call your GI hospital social worker
There are different private drug cards that you can still get on Medicare.
Needy meds
https://www.needymeds.org
 
Thanks Pinguino.

Called the number listed and ended up with the same number that said I was making too much money. I am constantly working with Jansen to see any other ways to get into a program but so far no luck.

I am working with the hospital to see if I can get the injections given by them, I hear there is a substantial discount.

By the way: I just injected myself three days ago and seeing again improvements, less bowel movements a day, more solid stools. I have heard that Stelara half life is 35 days so right now I am on a 80 cycle.
 
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