Tuesday, August 26, 2008 May, Community Member, asks

Q: The cost of Enbrel & the possibility to get off in the future

The cost of Enbrel & the possibility to get off in the future


I am planning to start Enbrel shots two times a week soon. When I saw the cost of the medicine yesterday, I could not believe it. Luckily my husband is not retired yet (he is close to the age). I only need to pay $20 co-pay. For people don't have a good coverage, how could they afford. The listed retail price is $683.65! . If I have to take this medicine the rest of my life, it will be a big burden for sure. I would like to know whether medicare would cover any.

 

Is there any chance to get off the medicine in the future if I get better? I know right now I do need to take some medicine to help me get off Prednisone.

 

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Answers (4)
Casey McNulty, Health Guide
8/27/08 10:37pm

Hi May,

 

Thank you for your question! There is a patient assistance program for Enbrel. It allows you to get a few weeks of free medication. You may be interested in applying for this program once your husband retires. (You would not be eligible for this program if you have Medicare, however.) You can learn more about the patient assitance program here. It's also possible that your future insurance company will cover Enbrel with a similar copay to your current plan.

I don't know that there's a limit on the length of time that you can continue to use Enbrel, but for some patients the medication stops being effective after a long period of time. Some studies have shown the medication to remain effective and with few side effects for several years, but the medication affects each person differently and you and your doctor will have to determine the best course of therapy for your individual case. I hope this helps!

 

Best of luck,

Casey

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May, Community Member
3/22/12 12:39pm

Hi Casey,

 

Thank you for your response.  Yes, you are right.  I am no longer on Enbrel cause I have allergic reaction.  I have changed to Humira and now is on Synponi.  Right now one shot without coverage costs over $2000.  It is one shot each month.  Since I posted the question, I have found out that Medicare will cover the IV injection med Ramicade.  You will need to sit in hospital for three hours to have the injection done.  Like you said, how long Ramicade would work is hard to say.

 

I am still very hopeful that one day I would get off this kind of medision.  Beside morning stiffness on my fingers for awhile, I am function as normal person.  I believe eating healthy, sleep well, exercise daily and stress free are the key to better health.  Only people went through this kind of pain can understand the suffering.  I know that stress caused my inmune went haywire 15 yrs ago, I will not allow it happen again.  Thank you for your input. -May-

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Jack keenan, Community Member
11/ 7/08 5:54pm

IF YOU ARE VETREN PLEASE GO TO THE VA and see a ruematoligist to get enbral for      $8.00 a monthCool

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ACHIEBONES, Community Member
1/ 3/12 7:50pm

I WAS ON ENBREL FOR OVER 8 YEARS THANKS TO MEDICAID BUT WHEN I GOT REMARRIED THE MEDICAID DROPED BECAUSE ME INCOME WAS TOO HIGH.

I AM DRAWING S.S. DISABILITY AND HAVE MEDICARE BUT THE OUT OF POCKET PAY WAS OVER 1000.00 A MONTH.

I STOPED TAKING ENBREL ALMOST A YEAR AGO AND AFTER ABOUT 8 MONTHS WITHOUT IT THE PAIN IS EVEN WORSE THAN BEFORE I STARTED TAKING IT, SO THE ANSWER TO QUESTION 1 IS NO, MEDICARE DOES NOT PAY FOR THIS TYPE OF MEDICINE AND NO YOU CAN NOT EVER STOP TAKING IT. SORRY FOR THE BAD NEWS BUT THERE IS NO WAY TO SUGAR COAT IT.

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OWOOD4, Community Member
3/22/12 12:10pm

Call or email the SAA (Spondylitis Association of America?? I believe that is the acronym). I was able to get my 1st 6 months free and then a $10/month co-pay for life. You do not have to join the association; however, a small donation is a small price to pay for their assistance!!!!

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By May, Community Member— Last Modified: 06/15/12, First Published: 08/26/08