#81 ·
wanderingsailor52 said:I just started biologic therapy recently, so maybe I can be of some help.
In the US, you can only get biologics through Medicare (correct me if I'm wrong), and the cost is covered by the hospital systems. When my specialist offered me BT, he asked if I wanted to self-administer it every two weeks or come into the clinic every six months for a two-hour session.
I'm on Humira. I inject it myself every two weeks, and I just "request" my next supply over the phone a week before I need to apply it. I think there are about 13 of us on BT in my county, and nationwide, I'm not sure, maybe around 1,000 if I recall correctly.
I was diagnosed with RA five years ago, so when I was 33, following knee surgery from a sports injury. I'm 38 now.
Over those five years, I tried sulfasalazine, which was a total bust, and ended up on a mix of methotrexate, Arava, and Decortin, along with the usual painkillers—mostly ibuprofen granules and Advil.
I stayed on that last combination for quite a while and it actually worked best for me, but whatever.
For your BT to be approved, the doctor has to submit a request, which first goes to a hospital board and then to a Medicare commission.
You have to run a whole series of tests—I assume you already know this—which all need to be attached to the application.
Basically, you have to meet these criteria: http://www.reumatologija.org/Preporu...nk=RA_HRD_2013
I guess as long as you don't show that necessary lack of response to standard treatment, the therapy won't do much. When the doctor submits the request, they basically use a calculator to crunch all these different factors and indicators; everything has to line up and show results that are worse than the recommended threshold.
But if you have the full documentation to satisfy the guidelines from the American Rheumatology Association, I don't see any reason why you couldn't get approved. It shouldn't matter where you're being treated. But that's just my opinion... 😢
I could ask my doctor about your situation; he’s an amazing guy and we have a really good relationship.
I'm seeing him at the end of January.
TapaTalk
My Humira was approved just last week, and after spending some time digging through Google, I must admit—I’m terrified. The list of side effects is... extensive. We’re talking everything from various infections to benign tumors, even skin cancer. Apparently, there's a one-in-ten chance for some patients.
I’m curious—which side effects have you actually experienced? How do you feel once the medication settles in?
It was prescribed for my hidradenitis suppurativa. But honestly? I am dreading actually starting this therapy.