Maintaining Humira Eligibility (Australia)

[Gra]

So far I have had the initial 12 week trial of Humira, followed by my first assessment (which was good), and now I am nearing the end of my second Humira script (24 weeks/12 pens), and now have one pen remaining. I have an appointment to see my GI tomorrow to renew my eligibility for another 24 weeks.

Looking at the MyHumira website, it says I have to keep showing an improvement to maintain my eligibility and for Medicare to approve my continued Humira program. But this seem to defy logic. If I am doing well and have, for instance, one BM per day, am I now supposed to "improve" to only one bm every two days?

I know that some people in Australia have been on Humira for 10 or more years, does that mean they have to demonstrate that they are as well as Superman? I don’t see how "continual improvement" is possible.

At the moment Humira has stopped the inflammation in my gut, is enabling me to sleep through the night without pain, and have regular BM's. I have also started working again (albeit only two days a week right now), when my Crohns was at it's worst I had to stop completely stop working for months.

How do other Aussies on Humira manage to keep Medicare happy?

 

[lost kitten]

You don't have to continually improve, it's more about maintenance and making sure Humira is continuing to work for you- CDAI score not increasing dramatically etc. My scores have been around the same since my 2nd script and haven't had any problems.

 

[DustyKat]

lost kitten is right Gra. I think you are taking 'keep improving' too literally and perhaps Medicare should phrase things more appropriately. Not surprising since they can't even spell Crohn's correctly (I have contacted them about that so we shall see :lol

What it means is that since you commenced the drug you have shown improvement of your symptoms and you have maintained that improvement i.e. your symptoms aren't worsening.

Dusty. xxx

 

[Gra]

Thanks Kitten and Dusty. That makes a lot more sense.
Gra