I have been on Orencia for over 2 yrs and 6 months without it. After 12 yrs of RA, we (my RA dr. and me) have found this to be the only treatment that I have not developed an allergy to, or had no help from. Yet, it is so very expensive, that every year, I struggle to find the funding to help with my copayments. For the past 2 yrs, I have had Medicare Advantage w/AARP, and they billed my $2500/mo medication to Medicare Part D, which in 2 months, put me in the "donut hole" and my copayment of $651/mo went to $982/mo until I got out of the donut hole and then it went down to $400+. This yr (2014) I went with Humana Advantage and the medication cost is $1930/mo and my co-pay is $374/mo. I am on disability, but make too much with my early retirement checks to qualify for Medicaid or other state programs, but my income is less than $1700/mo and I can not afford my other meds, rent, groceries, and the rest (no frivolous...believe me). Does anyone have the same problem? I have had to go 2 months now without my infusion because all the foundations are out of funding for Rheum.Arth. and I don't have an extra $374 for my infusion yet. (I'm saving up). Bristol Myers who makes this drug, has a program to help, but you first must pay 3% of your annual income on medications to qualify for their assistance. That would take me months to do. I am appealing their decision. But this has been a problem every year, and sometimes more than once a year if I run out of funding. I feel desperate and degraded to beg for a drug that makes the difference between 40-60/mg prednisone day, and 6/mg day. It means the difference between whether I can get up out of bed, and walk with a cane, or be bedridden, and killing myself on high doses of steroids and narcotics. Why must the mfg. of miracle drugs make them so unavailable to the needy? I'm talking about the average 'joe' ... who could afford $2500/mo full price for this drug? Why price it that high?
Well, thanks for letting me vent here. I don't know what the answer is, but I'm having to go another month without my Orencia to see if Bristol Myers will consider my appeal for help before I reach 3% spent.
I'd like to hear from others who might share the same problems. It's never ending. I will continue to be on this drug until something else can be found. I've been thru all the more traditional treatments and became disabled 5 yrs after I was diagnosed at age 50. So will I have to continue to beg for help for every month's treatment? I can't bear the thought.