Switching to a Biosimilar
With recent conversations with my rheumy, I have been switched from Humira to Hyrimoz. I'm curious if anyone else has had this conversation with their rheumy in switching to a biosimilar and what you have noticed? Did you also have any insurance troubles with them covering the biosimilar?
Yes, I am on Hadlima. I think it works better than Humira. No insurance issues. I was the third person Optum Speciality had on it! The copay assistance is only 2k or one month. I take it weekly. That is not good because my deductible is 5k.
Thanks, Christine!
OMG, so sorry to hear about that high copay! But glad you are seeing results!
Hello, I had been on Remicade for 4 1/2 years when my insurance required my changing to the biosimilar. Prior to the change over, I was having wonderful results with few flares and minimal pain between infusions. After the change to the biosimilar, my pain was back to what it was when I was first diagnosed. It was unbearable. Fortunately, with the documentation of my lack of relief from the new medication, my insurance approved my change back to Remicade. As far as insurance payment, I am on traditional Medicare with a Medicare Supplement which between the two covers my infusions in full.
Thank you for sharing your experiences with biosimilars and insurance coverage. It can be scary and nerve-wracking when we need to change our medications that are working so well because of the formulary. I am glad you were able (and your body) was able to detect that it wasn't working for you asap. I know some people have even avoided changing to biosimilars by having their doctors write a letter to insurance mentioning how the medication is working, and it would be of detriment to the patient. But I know every case is different. I also have that type of insurance and grateful it covers things I need. -Effie, team member
