Sunday, July 26, 2009 jane asks

Q: Just diagnosed w/RA. Must decide on medicinal effectiveness alongside limited income

I was diagnosed with RA three days ago after trying to get a rheumatologist to see me since the end of May. I am a self-employed artist doing highly detailed work, and have been unable to do this work since the end of May. I am 53, and have been in reasonable health until now. I will qualify for the Canadian Pension Plan when I reach 65, but have no other pensions. I have some RRSPs, but not a lot. I currently live on below-poverty line money that is generated by my work, along with very small investment income. I have a drug plan that will cover 80% of Enbrel, which has been indicated as the best thing for me. However, I cannot afford the $2000/month gap that I would have to cover---it would financially wipe me out in short order.

Methotrexate/Hydroxychloroquine was indicated as a "third tier" medication for me. I understand that it is affordable, but that takes three months to kick in.

I need to work now, and I need to do the best thing for my body as far as the RA--both for the present and for the future in having to cope with this disease.

I would be grateful for any suggestions from people who are familiar with the medical system here in Canada, and what the best way is to do what, when.

Forgive my long-windedness--and kindly attribute it to the fear and disorientation I'm currently experiencing.

w/thanks

jane

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Answers (2)

Lene Andersen, Health Guide

7/31/09 12:32pm

welcome to the site! It's nice to see another Canadian here.

All meds take a while to kick in. Although in my personal experience Enbrel works really fast, I've heard other people for whom it's taken a couple of months to really show up. Methotrexate takes about 6-8 weeks to work, so whether you go with one or the other, it's possible that it would take about the same amount of time for both to be effective at a level that can see you back at work. Depending on what province you live in, you may have options to help you with the $2000 portion of Enbrel that you have to pay - e.g., in Ontario, there is the Trillium Drug Program that will help you with medication costs that are high compared to your income.

I would recommend that you speak to your rheumatologist about the issue and that the two of you have a conversation about pros and cons in terms of cost and need for the meds to kick in quickly. Your doctor may also have some samples or maybe one of the patients who couldn't use Enbrel has left some with them that they can give to another patient (in the past, I've benefited from somebody else's meds that didn't work for themed and subsequently when I switch from Enbrel to Humira, I left a few doses of Enbrel with my doctor that later helped someone else who was waiting for funding approval) You can also ask about bridging the gap with prednisone, which can work quickly and enable you to get somewhat back to your life while you wait for the other meds to kick in. I would also suggest that you speak to your pharmacist about drug assistance programs - my pharmacist is the one who told me about the Trillium Drug Program.

Good luck!

ibme

10/12/09 8:27pm

Hi Jane, My name is Jane also. Anyway, I was just put on Enbrel myself. I too could not afford it. I would of had a 75.00 co-pay. Anyway I got on the Enbrel web site and

they have a payment assistance program. It is free for the first six months and Ten dollars a month for the next six months. I think they also will continue to pay past the oneyear amount of time. Check it out! Good luck to you and I hope this info helped.

Karen

11/ 4/10 2:28pm

I signed up for this program as well, and will be picking up my first scrip using it today. I will let you all know how it goes! My copay would have been $500 a month with my Cigna/Medco insurance.

Q: Just diagnosed w/RA. Must decide on medicinal effectiveness alongside limited income

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