Re: Enbrel approval by insurance?

July 26, 1999

--- pbias@... wrote:

> From: pbias@...

>

> How did those of you taking Enbrel get it approved

> by your insurance companies? The FDA has approved it

> for RA but not PA as of now.

It never came up. I just called and they sent it

over.

===

, NJ Highlands

raharris@...

July 26, 1999

If you have a mail order prescription plan, you mail it in like you do any

other prescription with your check for the 3 month supply. They will call

the doctor for justification. Many of us qualify as sero-negative RA and PA,

and then they have to give it to us. This is not cheating-

it is meeting their demand that we fit in this ridiculous box they have

built. The categories shouldn;t matter in my opinion--if your doctor feels

you need it you should get it. Giving good doctors the grand inquisition

over Enbrel, Arava, Celebrex,Vioxx and anything new that comes out is

outrageous. It takes away a lot of time from our patient care. I know that

when I am in with my doctor he always has a stack of phone calls to return to

insurance companies. They are all from his patients insurance company from

the day before!

July 26, 1999

Boy..you are having bunches of trouble with your insurance company...I am

sorry. Since in many cases RA and PA have overlapping symptoms it is easy

for a doctor to make a diagnosis of a patient having both. In so many cases

the patient has indicators of both RA and PA. You should ask your doctor

what criteria he used to make your diagnosis and ask him to reevaluate you

for possible RA involvement also.

I was told by my doctor that Immunex is currently doing clinical trials and

is expected to get Enbrel approved for PA soon...as well as certain cases of

heart failure. Good luck, Annette

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