Cost of Actemra??

[Guest guest]

Does anyone know what Actemra costs without insurance? Is it in the same price

range as Kineret?

When my divorce is final, I'll lose my current insurance so I'm trying to plan

ahead to what will happen. I'll be going on to Medicare and they pay for 75% of

the cost, but if it's like the other biologicals, that's still $300-600/month.

Apparently, after you hit about $4500 you are considered to be in the

catastrophic category which means there's only a $2 co-pay. I'll hit that

within about 2-3 months. But that co-pay restarts every year.

The Actemra site says that there are " patient assistance programs " that aren't

connected to them to help with large out of pockets. Has anyone used one of

them?

[Guest guest]

Hi ,

I don't know the exact cost of Actemra with or without insurance.  Cody's doc

quoted between $70,000 to $80,000 for 12 infusions back in January 2010.  It

took us until just last Tuesday for a confirmation from Blue Cross.  Cody also

has MA.  MA had denied the Actemra because he was never on Embrel or

Medotextrate only Kineret.  I had to get the procedure and diag codes, call

them into Blue Cross for them to run a test claim.  I wasn't prepared to drop

seven grand for his infusion today.  Then the doc stated today, that Cody may

have to do this twice per month the first few months, and the insurance I

believe covers for 12 infusion.  So, I know where you're coming from .  I'll

let you know if and when I get more information. 

Tricia (cody's mom)

________________________________

To: Stillsdisease

Sent: Mon, April 5, 2010 3:25:46 PM

Subject: Cost of Actemra??

 

Does anyone know what Actemra costs without insurance? Is it in the same price

range as Kineret?

When my divorce is final, I'll lose my current insurance so I'm trying to plan

ahead to what will happen. I'll be going on to Medicare and they pay for 75% of

the cost, but if it's like the other biologicals, that's still $300-600/month.

Apparently, after you hit about $4500 you are considered to be in the

catastrophic category which means there's only a $2 co-pay. I'll hit that within

about 2-3 months. But that co-pay restarts every year.

The Actemra site says that there are " patient assistance programs " that aren't

connected to them to help with large out of pockets. Has anyone used one of

them?

[Guest guest]

Hello ,

I have had two Actemra infusions. So far it seems more effective than the

previous IV infusion, Orencia, and the self-injected Kinaret and Humira. The

manufacturer Roche will pay for the first three infusions that covers the cost

of the medication not the cost of the infusion process. Their patient assistance

program covers between three and four hundred dollars per infusion. As to the

cost of an infusion I do not believe even my Rheumatologist has a price yet but

it maybe similar to Remicade.

Harry S.

To: Stillsdisease

From: shoobeedo@...

Date: Mon, 5 Apr 2010 19:25:46 +0000

Subject: Cost of Actemra??

Does anyone know what Actemra costs without insurance? Is it in the same price

range as Kineret?

When my divorce is final, I'll lose my current insurance so I'm trying to plan

ahead to what will happen. I'll be going on to Medicare and they pay for 75% of

the cost, but if it's like the other biologicals, that's still $300-600/month.

Apparently, after you hit about $4500 you are considered to be in the

catastrophic category which means there's only a $2 co-pay. I'll hit that within

about 2-3 months. But that co-pay restarts every year.

The Actemra site says that there are " patient assistance programs " that aren't

connected to them to help with large out of pockets. Has anyone used one of

them?

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[Guest guest]

Thank you Tricia. That's why I've started my doc on getting the referral

through now before I'm desperate. I have failed on MTX and Enbrel, but I

haven't been on Humira and the insurance companies look for anything they can

find to refuse coverage.

And thanks to those who posted about the Patient Assistance Programs.