It Just Doesn't Make Sense

By CommunityMember267

1 min read

I take Enbrel and have for 7 years. I always received assistance from Enbrel.

Why does RA medication cost so much?

When you turn 65, and go on Medicare, Enbrel stops the assistant. I didn't know this until I couldn't get my meds.

Insurance brought it to $2000 a month! It just doesn't make sense. It took me 4 months without meds to find help.

Amgen Foundation pays for the meds. I can't understand the price of meds.

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RHall Community Admin
Hi <inline-mention username="CommunityMember267" user-id="4687433"/> - thank you for sharing. I'm really sorry you're experiencing this. Unfortunately, this is something many others can relate to. Here is an article sharing others' thoughts on financial challenges with RA and also some resources that may be helpful for you: <a href='https://rheumatoidarthritis.net/living/financial-stress' target='_blank'>https://rheumatoidarthritis.net/living/financial-stress</a> - Warmly, - Reggie, <a href='https://rheumatoidarthritis.net' target='_blank'>RheumatoidArthritis.net</a> team member
trish53 Member
 CommunityMember267 - I did not sign up for drug coverage with Medicare originally because I don't take meds. 2 years I ago was diagnosed with Hep C, needed treatment, found out if I had Medicare's drug plan it was going to cost a lot, fortunately I was given the meds by the Drug Company for free. I did finally sign up for the drug component when I switched from regular Medicare to an Advantage plan. I am now charged about $6.00 a month late enrollment penalty for not having drug coverage from the beginning but that's okay because I'm almost 70 and the cost of those pills was $1300. PER DAY!! I took them for 8 weeks! It is crazy that this is a thing, I lucked out by not having coverage in the beginning. I hope you find some help in getting your meds covered.
Daniel Malito Moderator & Contributor
Same. I had to find a foundation to pay the copay for my Kineret. A lot of scholarship programs actually won't pay if you have insurance like Medicare. It's a bizarre system for sure. Fortunately there are some programs that can still help. If you need any more assistance let us know! Keep on keepin' on, DPM
1. christine.laaksonen Community Admin
 Hi <inline-mention username="KimSeattle" user-id="8803196"/>, I'm not entirely sure of the foundation Daniel spoke of, so hopefully he can go into a little more detail/specifics in his reply, but we do have a few articles with some resources for managing healthcare costs, <a href='https://rheumatoidarthritis.net/resources-cost' target='_blank'>https://rheumatoidarthritis.net/resources-cost</a>, and this article has some information for special groups, <a href='https://rheumatoidarthritis.net/resources-veterans-lgbtq' target='_blank'>https://rheumatoidarthritis.net/resources-veterans-lgbtq</a>. (I realize you might not be considered one of these "special groups" but I wanted to share it with you just in case.) Hopefully some of this information can be a starting point for you! Wishing you a gentle day. -- Warmly, Christine (Team Member)
2. Daniel Malito Moderator & Contributor
 <inline-mention username="KimSeattle" user-id="8803196"/> Hi, I was going to make a list but it looks like they already made one! https://www.medicarerights.org/fliers/Help-With-Drug-Costs/copay_charities.pdf?nrd=1 Check it out, these are charities that may help!! Keep on keepin' on, DPM
Ajaybe Member
I can relate. I have RA, Sjogren’s and Raynaud’s. I take Rituxan for RA; Restasis and Xiidra for dry eye due to Sjogren’s. All three are very costly even with a Medicare Advantage plan. I was able to get the meds for free via patient assistance programs for the manufacturers. Thank goodness because I wouldn’t be able to take any of them if I had to pay out of pocket.
1. Ajaybe Member
 <inline-mention username="KimSeattle" user-id="8803196"/> Yes, I am on a Medicare Advantage plan. It depends on the manufacturer, but some do have programs for people on Medicare. You have to meet the qualifications. Google patient assistance program for the manufacturer of Actemra and call the number provided. They should be able to answer your questions. 
2. Richard Faust Community Admin
 Hi <inline-mention username="Ajaybe" user-id="3185012"/> and <inline-mention username="KimSeattle" user-id="8803196"/>. To follow up on what Jo said, here is the link to SHIP - the State Health Insurance Assistance Program for navigating Medicare: <a href='https://www.shiphelp.org/' target='_blank' rel='noopener noreferrer ugc'>https://www.shiphelp.org/</a>. They offer unbiased information in that they are funded by the Federal Government and not trying to sell a product, unlike insurance brokers. Hope this information is helpful. Best, Richard (RheumatoidArthritis.net Team)
KimSeattle Member
A Neighbor who is on MediCare gets his expensive Meds from Canada via <a href='https://CanadaPharmacy.com' target='_blank' rel='noopener noreferrer ugc'>CanadaPharmacy.com</a>. It is the only way he can afford his Medication. Does anyone else here get their Meds from Canada??
1. Erin Rush Community Admin
 <inline-mention username="KimSeattle" user-id="8803196"/>, I am not sure if any of our members in the US use Canadian pharmacies, but I wouldn't be surprised. It's perfectly legal and your doctor should be able to write you a paper prescription, especially if they have reservations about sending a prescription to an online pharmacy. I know you know this, but I feel like I have to say, please do your research and make sure you are using a reputable pharmacy. Manay Canadian pharmacies are used to Americans buying prescription medications from them, so that part shoudn't be a problem. Best, Erin, <a href='https://rheumatoidarthritis.net' target='_blank'>RheumatoidArthritis.net</a> Team Member.