Why I Changed My RA Biologic
I did something a little crazy, but it made sense to me: I changed my biologic.
My previous one was working great. I had no adverse reactions, and I liked that it was an infused medication. I have been using it since 2013, and in that time, it has worked with near perfection.
Sure, there have been some of those common questions. Is this flare because the medication stopped working? The answer always was no; my numbers have been perfect.
Trying out many different RA biologics
This starkly contrasted with the other 4 biologics I have used over the past 23 years. In each case, my biologic medication either did nothing, or it worked briefly and then stopped working altogether. One of them, Remicade, worked like a charm for over 6 years, but it stopped working. Then I started the yearly slide. I tried Orencia, Actmera, Cimzia, and Simponi.
My rheumatologist was at his wit's end, and finally, he said if I wanted to feel better, I would need to take Rituxan. It was the last available medication, and I had said I would never take it. After a brief time, I could not stand living with my symptoms, and wow, it worked. I have used Rituxan for the last 10 years, and it has performed marvelously.
I wanted to change my biologic
Then I told my new rheumatologist I wanted to change. She was against it. She said that she felt it was a gamble I should not take. No, I insisted.
We talked about how we would know if I needed to come back to Rituxan, and if it did not work, it would take one full cycle using a medication that did not work to get back to one that did. I listened politely and told her I insisted we make a change.
My wife, Sheryl, was against it. She questioned my resolve, our ability to keep doing the many activities we love, and my sanity. I told her I had complete resolve in this matter and I had made a decision.
Facing questions from hospital staff
The hospital infusion center called and asked if I was sure. Yes, I said. "There is no financial advantage for you," they told me. I said I knew that, but I had to follow my own advice. I reassured them I would hold them harmless for the change in medication. Then I also told them I would find a new infusion center if they could not deliver it. The caller said there was no need to do that.
Then, on the infusion day, my infusion nurse said she did not understand my desire to switch. "I imagine not," I told her. I felt so strongly about this that I was doing it because I felt I had to do it. It was a personal choice.
Switching to a biosimilar for RA
So, what was this significant change? I opted for Ruxience, a biosimilar of Rituxan. Why did I do it?
To answer that, one has to go back to 2016 when I attended the American College of Rheumatology annual meeting. I attended a debate between 2 rheumatologists. The question was whether patients should use biosimilars.
I went to that session strongly against anyone suggesting I switch to a biosimilar. Along the way, I really took the issue to heart and researched the topic. After 5 years of study, I conceded that maybe there is something that makes sense.
Why did I decide to switch?
My change of heart did not happen overnight; the trail from "No" to "Yes" was winding. But I got there. I became convinced that biosimilars would be safe and effective, and that I may benefit through lower costs.
Once here, I began telling everyone these medications will someday tremendously lower the cost of treatment. It will take more patients adopting them, and it will take time, but imagine reducing the cost of these medications by 40 percent or more. I believe more insurance companies will approve biologic medications if competition exists.
The only way to have that competition is for somebody to step up. I followed my own advice; I decided to believe in these medications and the science behind them. I didn't even consider it a brave choice. For me, it was rational.
I have not been disappointed
So, when my infusion center announced it would carry Ruxience, I asked to be placed on it. I was not the first and will not be the last. But I may have been the first to ask for the change when the branded medication worked well.
In later posts, I will discuss the sea of change in the types of biologic medications now available and how my experience turned out. But as a preview, I will let you know I have not been disappointed.
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