Re: Re: /RA question

[Guest guest]

Hello ,

I suppose I asked the question because I would never take a drug just

because my rheumy, or any doctor told me to. You must be your own healthcare

advocate. Doctors are not gods. Most of the time, they do what their specialty

group maintains, what the research shows, and what has worked for other

patients. Sometimes, early research hides some side effects. Sometimes, as with

Merck & Vioxx, the drug company hides information.

I do not know what kind of doctors you are seeing, but I would be

seriously concerned if I believed my rheumy or any doctor would financially

benefit from prescribing a medication -- it is unethical and illegal.

I do not know what kind of infusion you receive but biologic meds are

very expensive to produce. For example, Remicade is only dispensed in 100mg

increments. Each 100mg bottle costs $300-$800 depending on the negotiated price

by the insurance company. Getting an infusion in a center adds to the price --

you are taking up a chair. I have received Remicade in my rheumy's office, in

the outpatient center at a hospital and at home (depending on the type of

insurance I have had). The cost per treatment at the hospital was over $4,000.

The price at my rheumy's office was just over $3,000. Taking it at home is by

far the cheapest. The total cost is $2000. These prices all include the cost of

the medication.

If the bulk of your pain is from OA, then taking an infusion might be a

waste off time. You should talk to your rheumy about it.

As for you and your husband having similar conditions, sometimes we seek

out people that will understand. A few of my good friends have some connection

with RA but I seek them out through my work with the Foundation. I put myself in

situations that make me less rare.

As for the wait to see a rheumy, rheumys do not just treat RA -- most of

their patients have OA, and that number will just increase the older our society

gets. I understand why some have stopped taking Medicare, but they could be

shooting themselves in the foot. As baby boomers age, and develop OA, many will

only be on Medicare. If they are lucky enough to have private insurance, it will

only be secondary.

As for having a problem changing rheumys, I have an HMO and I have never

had a problem. I have gone through 4 PCPs and 3 rheumys. Each time I changed

rheumys or PCPs I had very good reasons and I wrote letters to my HMO and to the

state Insurance agency. It resulted in 2 of the doctors being dropped from my

plan. If you read your " Evidence of coverage " booklet it lists your rights as a

member of the insurance company. One right is the right to change doctors if it

is in the best interest of your health.

Speak up for yourself. Otherwise, how will your doctor know your concerns?

Take care,

Steph in VA