Re: Sleepiness, Insurance Co. will not pay for doctor admin injections

[Guest guest]

I just posted yesterday about this, but I'll add it again. My docs office has

me wait for 30 minutes, but they have given me an epi-pen, which I must have

with me when I get my shot and must promise them to keep it with me for the 24

hours after the shot. So---I've already put it in my purse. In the 20 years

I've had mildly severe asthma thank God I have never had an anapylactic episode.

I'm sorry that you are caught in between your doctor and your insurance co.

Hope you can get things worked out and continue your shots.

arbarj2 <arbarj2@...> wrote:

Hi All:

I have been reading the posts about sleepiness. I receive 3

shots....3.75 every 2 weeks and have for the last 4 years and have

never been sleepy after the shots. My IGE is through the roof.

Xolair has been a wonder drug for me. I was allergic to almost every

antibiotic in pill form known to man. I was at a point that when I

needed antibiotics, I had to have IV therapy for the doses and was

tied

to the hospital or at home IV treatment for all of the lung

infections

I had.

Since I have been on Xolair, I am now able to take Cipro once again

and

Ketek (used vary sparingly because of kidney problems associated with

the drug). No IV therapy for last 3 years.

Unfortunately, I have not been able to lower the dosage of the

Advair.

I want to get off this asap because of the steroid component in the

medication. I am diabetic...........probably from all the prednisone

that I took over the last 15 years.

I started doing Xolair shots at home and found that it was much more

convenient than going into the doctor's office..........BUT......I

received a call from his office INFORMING me that he would not order

the medication refill to be shipped to my home, but I had to come

back

to his office and wait for two hours..........IS HE KIDDING

ME..........I have other medical issues that I cannot sit for that

long

and his office is usually standing room only..............HOW MUCH

MONEY DO THESE DOCTOR'S WANT??? CIGNA, my insurance company, has

deemed this a self injectable drug and WILL NOT pay for office

injections. I called CIGNA last week and it is still on their home

injection drug list and has not changed, so the administration of the

drug in the office is NOT a covered expense. So who is going to pay

for this...........and that is how I left it with the nurse in the

office.

I think this is a " crock " especially when there has not been any

incidents of any reactions for me over the four years of me receiving

injections.

I don't want to stop taking Xolair, but I cannot imagine spending the

two hours after each shot or about 3 1/2 hours every two weeks in his

office by the time I get registered pay the deductible and wait to be

called and then receiving the injections.

Sign me...........Ticked off!!!

---------------------------------

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[Guest guest]

I also do home injections and have CIGNA as well. My

Pulmo has allowed me to continue to do self injections

with conditions. I now have an epi pen at home along

with an actual " plan " just in case something happens.

See if she/he can come up with another way to go

about you getting your injections. (If not, since you

have insurance, maybe you might want to find another

Pulmo or Allergist who takes CIGNA.) My whole thought

on this is that the FDA has blown this whole thing out

of proportion.

As for your IgE levels that are through the roof,

your levels are ALWAYS going to stay high or even get

higher. I am part of the Xolair Patient Speaker

program and I work with an AWESOME Pulmonologist who

is part of the Doctor Speaker Program. He explains to

the people he give lectures to that when a patient is

injected with the " anti-IgE " it takes time for it to

beak down. Because of that the patient will normally

show at least a 1 and a half times increase in their

IgE levels. My own levels were 287 initially and then

524 after. So you never go buy the levels after an

individual has had even their first injection.

I know there is a nurse in here, who does a great job

of explaining things better, who might be able to

explain why the levels go up better than I just did

and I hope she sees this....if not maybe Doug can

help explain it better -HINT HINT!!

**note from Doug:

Why thank you but I think our medical professionals can do a much better job

than I

Doug

[Guest guest]

On 4/5/07, arbarj2 <arbarj2@...> wrote:

>

>

>

>

>

>

> Hi All:

>

> I have been reading the posts about sleepiness. I receive 3

> shots....3.75 every 2 weeks and have for the last 4 years and have

> never been sleepy after the shots. My IGE is through the roof.

>

>

*snip*

> I started doing Xolair shots at home and found that it was much more

> convenient than going into the doctor's office..........BUT......I

> received a call from his office INFORMING me that he would not order

> the medication refill to be shipped to my home, but I had to come

> back

> to his office and wait for two hours..........IS HE KIDDING

> ME..........I have other medical issues that I cannot sit for that

> long

> and his office is usually standing room only..............HOW MUCH

> MONEY DO THESE DOCTOR'S WANT??? CIGNA, my insurance company, has

> deemed this a self injectable drug and WILL NOT pay for office

> injections. I called CIGNA last week and it is still on their home

> injection drug list and has not changed, so the administration of the

> drug in the office is NOT a covered expense. So who is going to pay

> for this...........and that is how I left it with the nurse in the

> office.

The FDA has all the doctor's running scared. A black box warning is

not a joke on medication, especially since this particular says you

can get problems from the second the shot is given up to 24 hours.

All the doctors are seeing right now are lawyers licking their chops,

that that one in billizion person will have some serious adverse

reaction, winding up brain half fried, on a ventilator with all the

persons loved ones looking for blood.

Would I be willing to lose my practice to a black box warning?

Because if SOMETHING happens, you bet your sweet inhaler, the lawyers

will be all over that black box warning like white on rice.

I don't know if I would be willing to do that.

And you can not sign away liability with medical matters.

We here probably have a better chance hitting the mega ball lotto than

an adverse reaction to Xolair. Thanks to the FDA, the doctors are

practicing defensive medicine. That is why the doctor is pulling the

rip cord on home injections, and making us do that glorious 2 hour

wait.

These are your options..

-Get another doctor who will sign off on home injections. Some folks

here are extremely lucky, and their doctors are still letting them. I

live in a major metro area, and NO doctors here are doing self

injections anymore. I'm lucky my allergist is still doing them in his

office. Most have punted the Xolair injections to the infusion

centers (fate worse that hell).

-Try whittle down the wait time in the office. Though my allergist

made me sign a form that I MUST wait the whole 2 hours, or else no

more shots. That beats the 3 hour ordeal in the infusion center.

My allergist lets me wait in the treatment room during the two hours.

At least I can lay down, move around and more or less get

comfortable. Beats the cattle call in the waiting room.

I have major neck and spinal problems, and there is no way I could sit

in those office chairs for two hours.

I don't have a choice. I need Xolair. So, I pay the $68 shot fee. I

wait the 2 hours. I try and not bitch and complain to folks who's

hands are tied by FDA regulations.

I get Zen. Could be worse, like being on hemodialysis for 4 hours,

three times a week, or chemo, Though, I'm the most un-Zen like person

on the plant, and I usually wind up fuming at the FDA.

Vent your fury at the FDA. The doctors are thrilled with these stupid

changes, either.

Nan

[Guest guest]

My apologies for misspelling anaphylactic! When I reread my post my face turned

red--I am a retired English teacher!

Adah Voigt <asthmatic50@...> wrote: I just posted yesterday about

this, but I'll add it again. My docs office has me wait for 30 minutes, but they

have given me an epi-pen, which I must have with me when I get my shot and must

promise them to keep it with me for the 24 hours after the shot. So---I've

already put it in my purse. In the 20 years I've had mildly severe asthma thank

God I have never had an anapylactic episode.

I'm sorry that you are caught in between your doctor and your insurance co. Hope

you can get things worked out and continue your shots.

arbarj2 <arbarj2@...> wrote:

Hi All:

I have been reading the posts about sleepiness. I receive 3

shots....3.75 every 2 weeks and have for the last 4 years and have

never been sleepy after the shots. My IGE is through the roof.

Xolair has been a wonder drug for me. I was allergic to almost every

antibiotic in pill form known to man. I was at a point that when I

needed antibiotics, I had to have IV therapy for the doses and was

tied

to the hospital or at home IV treatment for all of the lung

infections

I had.

Since I have been on Xolair, I am now able to take Cipro once again

and

Ketek (used vary sparingly because of kidney problems associated with

the drug). No IV therapy for last 3 years.

Unfortunately, I have not been able to lower the dosage of the

Advair.

I want to get off this asap because of the steroid component in the

medication. I am diabetic...........probably from all the prednisone

that I took over the last 15 years.

I started doing Xolair shots at home and found that it was much more

convenient than going into the doctor's office..........BUT......I

received a call from his office INFORMING me that he would not order

the medication refill to be shipped to my home, but I had to come

back

to his office and wait for two hours..........IS HE KIDDING

ME..........I have other medical issues that I cannot sit for that

long

and his office is usually standing room only..............HOW MUCH

MONEY DO THESE DOCTOR'S WANT??? CIGNA, my insurance company, has

deemed this a self injectable drug and WILL NOT pay for office

injections. I called CIGNA last week and it is still on their home

injection drug list and has not changed, so the administration of the

drug in the office is NOT a covered expense. So who is going to pay

for this...........and that is how I left it with the nurse in the

office.

I think this is a " crock " especially when there has not been any

incidents of any reactions for me over the four years of me receiving

injections.

I don't want to stop taking Xolair, but I cannot imagine spending the

two hours after each shot or about 3 1/2 hours every two weeks in his

office by the time I get registered pay the deductible and wait to be

called and then receiving the injections.

Sign me...........Ticked off!!!

---------------------------------

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