Cimzia
- Thread starter theend2
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My Butt Hurts
Squeals-a-lot!
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I don't have answers for your questions, but I see that you have already failed Humira and Remicade. Do you have any idea why they failed to approve you? If not - I believe you can call and get specifics. (When I was denied for a double dose of Humira, they said it was because I hadn't tried Remi yet)
I was just wondering what their reasoning was, since it seems they usually say you can't have Cimzia until you try the other two.
I was just wondering what their reasoning was, since it seems they usually say you can't have Cimzia until you try the other two.
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Hi theend2! I was on Cimzia for about 3 mths last March when I was getting no relief from Remicade. I am in Florida and it runs about 1500.00 if I remember correctly, although I was able to get the first 3 mths FREE thru Cimzia! It really was such a help, as at that time I had already racked almost $15,000 in medical bills. They were really great and sent me a green briefcase to keep up with all med records, diet, bathroom card, and several other things. They offer a health program, financial assistance, and home health program. I would recommend calling 1-866-4-cimzia 8-8pm est M-F, and see if you could possibly get in on this. It would at least give you the opportunity to see if it would work. Good Luck!!
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theend2 said:
No, unfortunately it did not. They put me on Cimzia as a last result to relieve a blockage but it was too bad so I had to have surgery anyway. I have not been back on it since then. Good Luck!
Candace
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Hey Theend. I also took Cimzia for a few months but my condition was bad enough that it couldn't be reversed through meds- so I can't report on its effectiveness. I was approved by insurance though, and didn't even have a copay. Insurance companies are weird about how they approve meds... maybe you can get your doctor to write a letter or change the verbiage in your dx to get them to approve? I've had to have doctors call or write letters before to get approval. Good luck!
I can't speak to the Ulcerative Colitis, but my wife has had it prescribed for Crohn's and the insurance company started giving us hassles about it too.
They still cover it, but have an insanely high co-pay ( as in hundreds of dollars).
Last year, they covered it completely, so I think they are re-thinking the coverage.
Best of luck to you...
--kevin
They still cover it, but have an insanely high co-pay ( as in hundreds of dollars).
Last year, they covered it completely, so I think they are re-thinking the coverage.
Best of luck to you...
--kevin
I just had my first injection of Cimzia two days ago. I looked through the mountains of pamphlets that I have received on it and it doesn't mention Ulcerative Colitis at all.
I can't speak to how well it does or not work because it's only been two days for me. But it is very expensive. The bill was included with my first two shots and it was $4500. But thankfully, I only have a $20 co-pay. My insurance denied it the first time but after my Dr spoke with them, they approved it.
I hope you find some relief soon!
I can't speak to how well it does or not work because it's only been two days for me. But it is very expensive. The bill was included with my first two shots and it was $4500. But thankfully, I only have a $20 co-pay. My insurance denied it the first time but after my Dr spoke with them, they approved it.
I hope you find some relief soon!
Sadly its seems to be all about the cash with these ins companies. The ins company told me that Cimzia was not FDA approved for Ulcerative Colitis. Last time I checked Ulcerative colitis was a lot closer to Crohns than RA. Crazy. Mean while I have to be on prednisone and endure all its loveliness because that's all that works. Sad. So sick of all the BS and ins companies.
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Ughh...so frustrating that they would use a loophole like the fda approval when your only other option is pred, which should only be used for very short term emergent situations. My doctor is a big proponent of giving biologics much earlier in the disease because that is exactly when they are most affective. Don't the insurance companies realize that Cimzia still cheaper than paying for surgeries, hospitalizations, etc.?
Does your doctor do enough arguing for you? (or does he have people in his office who are good at it and will do it?). Sometime you just need to wear them down with the right arguments but it's only medical professionals who can convince them not patients. I'm on a pretty stingy hmo plan but my doctor and his team don't give up until they get the answer they want. So far it's worked for me. Been on Cimzia for 8 mos and while i had to double the dose to 2x per mos. because it started not working on just once a month, it's been a really easy to tolerate drug for me. I'm just starting the new dose so too soon to tell whether it will do the trick. GOOD LUCK!
Does your doctor do enough arguing for you? (or does he have people in his office who are good at it and will do it?). Sometime you just need to wear them down with the right arguments but it's only medical professionals who can convince them not patients. I'm on a pretty stingy hmo plan but my doctor and his team don't give up until they get the answer they want. So far it's worked for me. Been on Cimzia for 8 mos and while i had to double the dose to 2x per mos. because it started not working on just once a month, it's been a really easy to tolerate drug for me. I'm just starting the new dose so too soon to tell whether it will do the trick. GOOD LUCK!
slice said:
Hi Slice I hope the new dose works for you and I am glad you have go some good results on it. As far as I know my GI fought to get me on it he sent 2 letters and still nothing. Why is it that we can understand the economics of this and they can't see it? Crazy isn't it.
