Hello. My daughter 10 years old after almost 18 months of symptoms has been diagnosed with Crohn's disease. Her GI wants to put her on Stelara and if not Stelara feels it is very important that she is put on a biologic. She has fallen from the 50th percentile in weight and height to the 5th. I find myself in the worst possible situation where my health insurance has a no specialty drug rider on the policy, they will not cover any biologic under any circumstances. We do not qualify for Janseen's Carepath assistance for copays because we have insurance but it covers nothing. We do not qualify for the other programs because they say our income is too high. The cost of Stelara, Humira or Remicade is more than my entire Salary after taxes and I will lose my house if I pay that much for medication. Has anyone been in this situation? How did you get the drug covered? Can you get the manufacturer to help? I don't know where to turn next.
Reply posted for janetteanso.
Reply posted for orthopt2003.
If your insurance won’t cover the medication go to the maker of the biologic website they have a lot of cost effective options as low as five dollars but it’s different with each company
Reply posted for orthopt2003.
Abbvie has a discount program initiated by your prescriber. But with me that was the easy part.
I made an appointment with my GI in January, didn't get the appointment until May 2 the Humira was approved quickly however, No one to blame but here at June 2 sttill no drug!!
wrong specialty Pharmacy,,, no dosage instructions , verbal requests required, wrong address on file, maintence dose approved before the loading dose,,,,,, it will go on and on! The insurance companies acted fine the Pharmacy benifits manager was fine both Kroger and Accredo were super fine. So it all goes back to the incompetence created by under paid, overworked and unexperienced provider staff!!!. My GI sees 60 patients a day at $346 per visit on average, then sits down with a donut and makes 3 girls do all the work. Be prepared!!!!!
Reply posted for orthopt2003.
Have you been able to find any help? Is the issue that your insurance does not cover the biologics like Humira and Stelara at all? I have contacted the manufacturers of some medicines through their websites and received some help with a copay card or other assistance. I agree the treatments are very expensive. Has your doctor been able to help with connecting you with resources who may help? I recently joined the forum and just saw your post, and I hope you have been able to find some answers. Affording this disease is always on my mind and it is the last thing you need to worry about when your family desperately needs a medicine.
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