Humira stopped due to insurance

[Bird22girl]

I will soon start amjevita due to my insurance no longer covering humira anyone else try this??

 

[dreamintwilight]

I'm in the same boat as you. Insurance is forcing me to switch to Amjevita effective January 2025, no longer covering Humira. I've been on Humira since 2010, which has kept me in remission. My GI doesn't seem to be concerned about the switch (and therefore is not inclined to go through the hassle of appealing), so I suppose that's what I'm going to do in January when I run out of my last Humira pens.

How long have you been taking Humira? Are you currently in remission? I'm hoping stable health will makeit more likely that the transition will go smoothly. I take weekly doses too, so am hoping there won't be issues getting Amjevita weekly, since even with Humira they still consider weekly injections "off label" dosing.

Have you signed up for the patient assistance program through Amjevita yet? I need to reach out and find out if they offer reimbursement to cover my medicine, which is how we have been paying for Humira (our insurance doesn't count co-pay assistance toward deductible or OOP).

Wishing you best of luck as you go through the same thing. Keep us posted how things go for you too!

 

[Bird22girl]

I'm in the same boat as you. Insurance is forcing me to switch to Amjevita effective January 2025, no longer covering Humira. I've been on Humira since 2010, which has kept me in remission. My GI doesn't seem to be concerned about the switch (and therefore is not inclined to go through the hassle of appealing), so I suppose that's what I'm going to do in January when I run out of my last Humira pens.

How long have you been taking Humira? Are you currently in remission? I'm hoping stable health will makeit more likely that the transition will go smoothly. I take weekly doses too, so am hoping there won't be issues getting Amjevita weekly, since even with Humira they still consider weekly injections "off label" dosing.

Have you signed up for the patient assistance program through Amjevita yet? I need to reach out and find out if they offer reimbursement to cover my medicine, which is how we have been paying for Humira (our insurance doesn't count co-pay assistance toward deductible or OOP).

Wishing you best of luck as you go through the same thing. Keep us posted how things go for you too!

Omg thanks for responding!!
I haven’t spoken to anyone for patient assistance yet. My GI doesn’t seem concerned either!! I’ve been on humira since 2022 and I finally feel OK so I don’t want to rock the boat LOL.
Let’s stay in touch and see how we both are doing if you don’t mind!?

 

[dreamintwilight]

Omg thanks for responding!!
I haven’t spoken to anyone for patient assistance yet. My GI doesn’t seem concerned either!! I’ve been on humira since 2022 and I finally feel OK so I don’t want to rock the boat LOL.
Let’s stay in touch and see how we both are doing if you don’t mind!?

Yes, let's definitely stay in touch/updated! Feel free to private message me if I miss a response on this thread, but I'm guessing our experiences might be helpful/relevant to others who may be in a similar boat. I 100% understand about not wanting to rock the boat with any changes. I'm hoping it'll be smooth sailing for both of us!

I did actually call the Amgen Support Plus program (for Amjevita) this week to get information on patient assistance and whether they had a reimbursement program similar to Humira. Good news is they offer both reimbursement as well as co-pay assistance to help with financial support! I still had to enroll in the Support Plus program (which is the co-pay card assistance program) so they could have a patient record for me, but then they sent me a link to sign up for their 3rd party reimbursement website. I realize not everyone is able to pay up front for medication and do reimbursement, but am grateful we have this option, which helps us meet our out-of-pocket max within the first few months of the year! I have other medical issues that require annual tests that are quite costly, so meeting our OOP max so early in the year really helps us financially!

I have one more refill of Humira left that I should be able to fill at the end of this month (if all goes as planned), so I actually might not end up needing Amjevita until February or March once I finish off my Humira supply. This will give me an extra buffer to sort out any delays that might happen with the switch over too (like prior authorization, prescription issues, etc).

 

[Anna's Bandit]

I was on Humira for 3 years. Got it for free from a patient assistance program. Have been on Stelara for 3 years and get that for free through a patient assistance program too. I am retired/disabled and collect SSD. I am low income. I do have health insurance through United health Care. Don't give up up, keep looking for resources !