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Real members of MySpondylitisTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.
June 14, 2023
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Answer Summary

Members shared practical strategies for affording expensive biologic medications like Humira when insurance won't cover them, with several... Read more

Members shared practical strategies for affording expensive biologic medications like Humira when insurance won't cover them, with several pointing to manufacturer patient assistance programs such as the AbbVie Patient Assistance Foundation, which can provide medications at no cost to those who qualify based on income, even for Medicare patients. Many emphasized the importance of requesting prior authorization through your doctor, exploring copay assistance programs that can reduce costs to zero, and considering alternative biologics like Cimzia or Simponi Aria that may be covered under Medicare Part B when administered at an infusion center. A recurring theme was the emotional weight of deciding whether to start immune-suppressing medications later in life, with members expressing both reluctance and hope as they weighed quality of life, disease progression, and the desire to stay active against the risks and unknowns of treatment.

A MySpondylitisTeam Member

@A MySpondylitisTeam Member I am on Medicare and do not qualify as someone who should receive financial assistance. I will see what options I have from my doctor at my next scheduled visit.

June 18, 2023
A MySpondylitisTeam Member

I'm so sorry to hear what you are going through Dinelle. It really is difficult to know how best to proceed in terms of medications. I too have always been very active and at 68 am still able to live an active life on most days. I am reluctant to take any drugs and want to see if I can manage AS without going on medications permanently. I will meet with my rheumatologist and discuss options in the coming weeks. I will certainly talk to my doctor about cimzia to get informed on that option.

June 21, 2023
A MySpondylitisTeam Member

I am 72 and recently dx with ankylosing spondylitis. Due to Medicare many options of meds are not available. My rheumatologist found cimzia abc it is approved my Medicare. I have been reluctant to start as my symptoms came on late in life. I know the dude effects are not good. I am able to do my daily activities but walking continually as a 2 mile walk is impossible. I e always been very active. So this is quite a life changing event.. my dr tell me rest is rust ; must keep moving. I am still debating an immune suppressant as cimzia (similar to humara “. I will discuss agsin with dr at next appointment. I have pain in my Savral iliac joints with partial fusion. This is how I was dx woth positive hlab27 gene. Perhaps you can ask dr for alternative meds. I also have psoriasis I’d scalp. Cimzia shoukd help this. At 73. I hate to lower my immune system. It is a very difficult educated decision. I wish you well

June 20, 2023
A MySpondylitisTeam Member

So my mom has had several assistance programs like I listed above. They cover the whole cost as she cannot afford the copay for the biological medications once they are prior authorized by physician. She is also on Medicare she still received and received the assistance for the drug cost through the company. Can’t hurt to try if you want to try that route.

June 19, 2023
A MySpondylitisTeam Member

Paying for Spondylitis Medication
Most people with private or employer-sponsored health insurance are eligible for copay assistance programs — many with a $0 copay — through the manufacturers of disease-modifying spondylitis treatments. Some people with low income and no health insurance may qualify for free spondylitis medications through nonprofit organizations or drug manufacturers.

https://spondylitis.org/resources-support/suppo...

https://spondylitis.org/resources-support/suppo...

June 17, 2023

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