Guest guest Posted July 12, 2002 Report Share Posted July 12, 2002 Hi I know the doctor in manitoba is advocating very strongly for ontario...guess you wonder why..she goes to the remoter parts of northwestern ontario to treat also...and boy do the doctors advocate for their patients ease.. one dayyyyyyyyyyyyyy perhaps hugs sam [ ] Biologics > In Ontario where I live,you have to have failed Arava and just about everything else before you can get coverage under a Schedule 8, which covers the cost of the biologics. I have failed them all,so it was not a problem for me to get the green light. However, we are fighting this criteria because this means we have some idiot in the government deciding what meds we should take and when . Don't get me started on this subject,it raises my BP. > > Hugs > June > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 27, 2003 Report Share Posted August 27, 2003 Hi everyone, I agree with the rheumy Sandy heard speak. My doctors believe one of the reasons I've had such a great response to Remicade is because I started it 5 months after I was diagnosed (8 months after the symptoms started). I started methotrexate 2 weeks after I was diagnosed. Regardless of potential side effects, I think it was the right decision.Take care, in VA ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > Help protect your PC: Click here to go to the Mcafee.com free online virus scan. From all the literature I read, the biologicals are indicated if the other DMARDs are not working. The insurance company I work for only will authorize them under those circumstances. However, I did go to a lecture given by the Chief of Rheumatology at Univ. of Calif. at San Fran. who indicates that he likes to put newly diagnosed patients on biologics with methotrexate stating that more recent studies indicate that they prevent the deterioration of joints over a longer course of time. There are still many scientific studies being performed. I do believe that medicine is very much a combination of art and science. From: "Harold Van Tuyl" Reply-Rheumatoid Arthritis Subject: Re: Am I contributing to joint damage? Date: Mon, 25 Aug 2003 09:13:23 -0700 How well RA needs to be controlled is a highly subjective thing. I've only had RA for about 20 months so I can't tell about the long-term effects of pain and/or swelling. Some people say that swelling is required for damage to be happening but others say that pain by itself shows that some damage is occurring. Also it probably varies from person to person. You seem to be quite young (I'm 75 so lots of people are young to me) and want to have an active life. My guess is that you would benefit from either an increase in your Methotrexate or addition of another mild DMARD such as Plaquenil or Sulfasalazine. Since you seem to be almost controlled with your current medicines I doubt that you are a good candidate for the biologics (largely because of the expense). Your doctor may not you straight answers just because he is trying to be honest with you. RA has enough different faces that there are probably more exceptions than rules. In fact if you get answers that are too definitive you might want to change doctors. RA requires patience and trial and error before you get to trial and success. I don't know of any other way. Good luck and God bless. Harold Van Tuyl (Grandpavan) ----- Original Message ----- From: Matthies Rheumatoid Arthritis Sent: Sunday, August 24, 2003 11:27 PM Subject: Am I contributing to joint damage? OK... need advice from you knowledgeable RA veterans. I am one of the lucky ones who methotrexate is seemingly working pretty well for. I managed to ween myself off the prednisone and now am taking 15 mg methotrexate weekly and 150 mg of an anti-inflammatory daily. I choreograph beam and floor routines for gymnasts as well as occasionally coach and I am starting nursing school this fall. Obviously what I am most concerned about is the what ifs and what nexts. I flare up after choreographing all day or if I'm on my feet all day (not to the level of many of you out there) but because joint pain (as a former gymnast) is something in the past I've been used to... I just kind of shake it off and keep going. (Even limping) Choreography is my moneymaker. Am I contributing to joint damage or is it an okay thing to continue if the pain tolerance is within reason and I am on a DMARD? I know it is something to run by my doc. but occasionally I get not so straight answers from him. I admire you all so much and your experience and wisdom. Thanks... Oh... by the way... no tumbles down the stairs lately. Must be that I'm back in the gym. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 28, 2004 Report Share Posted September 28, 2004 I am in the same boat as you are, Cristen. Mine is aggressive and stops responding to meds. I have Anthem and so far I haven't had any problems. If the med isn't formulary, I just have a higher copay. The doc can write to the insurance company as well or even call and request something to be approved. Best thing to do is call your insurance carrier and see what they say. So far I haven't had any issues, they even approved remicade (it had to be precertified) and I hadn't even used any of the other biologics at the time! Marina > Hi, > > Has anyone run into problems with trying to get insurance companies to pay for the biologics (enbrel etc) when first diagnosed with RA? I was told my RA is aggressive, so my idea is to try everything. > > Cristen > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2004 Report Share Posted September 29, 2004 I could not get on a biologic until I had an incomplete response to mtx. Insurance companies always want you to try the lower cost meds first and usually, if those don't work they will approve the higher cost ones. The cost to the insurance of a biologic drug is less than the cost over the life of a patient with untreated RA, since there can be so much damage and so many health problems with not treating it. The mtx did work for me in combination with prednisone for about 6 months. When my disease worsened and mtx was not enough, the insurance approved Humira. I didn't have any problems getting it approved, the rheumy's office handled all the paperwork. --- In , " Cristen s " <cdharriss@n...> wrote: > Hi, > > Has anyone run into problems with trying to get insurance companies to pay for the biologics (enbrel etc) when first diagnosed with RA? I was told my RA is aggressive, so my idea is to try everything. > > Cristen > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2004 Report Share Posted September 29, 2004 Ok, that is basically what my Rheumy told me ---I just wanted to be sure. Thanks! Cristen [ ] Re: Biologics I could not get on a biologic until I had an incomplete response to mtx. Insurance companies always want you to try the lower cost meds first and usually, if those don't work they will approve the higher cost ones. The cost to the insurance of a biologic drug is less than the cost over the life of a patient with untreated RA, since there can be so much damage and so many health problems with not treating it. The mtx did work for me in combination with prednisone for about 6 months. When my disease worsened and mtx was not enough, the insurance approved Humira. I didn't have any problems getting it approved, the rheumy's office handled all the paperwork. > Hi, > > Has anyone run into problems with trying to get insurance companies to pay for the biologics (enbrel etc) when first diagnosed with RA? I was told my RA is aggressive, so my idea is to try everything. > > Cristen > > Quote Link to comment Share on other sites More sharing options...
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