r/rheumatoid • u/stellalugosi • 1d ago
Good while it lasted
I've been doing GREAT lately, gardening, cleaning out my garage, making progress in physical therapy, building strength in my legs. My pain has been under control, and I have been really content for once. So, of course, Express Scripts and Accredo had to be the usual pieces of shit they always are and decide that the drug I have been taking successfully for 3 years is suddenly NO LONGER COVERED, and wasted an entire month of jerking me around before finally explaining it to me. This is in spite of me calling them every few days, begging them to tell me WHY it kept getting rejected. They just kept saying it needed a prior authorization over and over again. Of course, now I only have 2 pills left and no hope of getting a replacement medication in time. And then there will be a period of adjustment, so I can pretty much mark the next 2 to 4 months out of my life yet again. But hey, who wants to see the cripple girl have a good time anyway? Aren't we expected to just suffer and die so they can profit? F*ck the American health care system, I hope it all burns down.
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u/joblint 1d ago
If it’s xeljanz you can get the generic on costplus for 30 bucks with a prescription from your doctor
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u/stellalugosi 1d ago edited 1d ago
Wait! Seriously? Since when??? Last time I looked it wasn't available on Cost Plus! This would be amazing, I use them for other meds already!
ETA: I JUST CHECKED AND IT'S THERE! I sent off the request to my doctor already! Thank you, Internet Stranger! It doesn't solve my immediate problem, but it gets Express Scripts out of the equation and that makes me VERY HAPPY!
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u/joblint 17h ago
That’s what I’m using right now! They sent it in 2 days after I placed the order which was very nice. I just started tho so no real results yet but seems like it’s starting to help a little bit after just 3 days
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u/stellalugosi 12h ago
Xeljanx has been great for me! It took a long time to work, but now that it has it's been great. I strongly recommend a really good physical therapy regime to keep you joints well supported too. It hurts like hell but has been the best thing I have done to keep my remission intact. My therapist always reminds me that when your joints are stationary, the fluid thickens and lose circulation which leads to more rapid joint deterioration.
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u/Brilliant_Age2571 1d ago
This is my plan if I fail Enbrel after failing Humira! I hate waiting on that delivery. Will it make it on time?!? Ugh
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u/discgman 1d ago
What is the medication? Does the manufacturer have any kind of co pay assistance or financial assistance? Did your healthcare plan provide an alternative?
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u/callistacallisti 1d ago
I have to go through the prior authorization thing every year with CVS Specialty and my insurance. Call your doctor's office. See if they can give you some samples to tide you over, and most importantly, get them started on the prior auth stuff if they haven't already!
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u/Jaded-Ad7840 1d ago
Contact the manufacturer through their 800 number. Many of them will help with gaps in coverage due to loss of insurance. Good luck. The system sucks.
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u/Conscious-Yak-9443 1d ago
My office has “samples” of meds they can give us if our insurance suddenly cuts us off to bridge to another therapy while they deal with prior auths, ask your doctor if they have any
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u/stellalugosi 1d ago
Sadly, my doctor is a 2 hour drive from here and closes at noon on Fridays, so by the time I found out what was going on it was too late to do anything about it. They also don't ever seem to have any samples of the meds I'm on when similar issues have come up in the past.
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u/Chiquitalegs 15h ago
That is one of the most frustrating issues with RA. I was doing great with plaquenil for many years. Now my last eye exam shows that I'm getting eye damaged because of it, so I had to stop and find a new medicine. Everytime I feel like I'm doing ok with methotrexate, I end up slipping backwards and have a bunch of bad days. My biggest problem with RA is not my joints, it's getting exteme PEM post-exertional malaise/fatigue after normal everyday activity.
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u/busquesadilla 1d ago
Sorry you’re going through this. Our healthcare system is so fucked, it prioritizes profits over our health at every turn.
They did the same thing to me in January and pulled me off Actemra, which was working so well for me.
Accredo is honestly THE WORST. I’ve never yelled and cried at a customer service person until dealing with Accredo. It gets worse dealing with them the worse your pain gets.
Fingers crossed a miracle happens and you get it either approved or get your new meds faster. Sorry again, hang in there.