Road to Cosentyx, or should I say Co$entyx

[Caroline]

Yes, big pharma and just as bad, crooked insurance co. 

That looks like a straight psoriasis treatment? I have severe psoriatic arthritis. Although my nails are affected, my skin is not.

Than you have the same as me.
I also do not have problems with my skin.
PsA is in fact equal to Psoriasis. It is the same disease with the same cause. Most medications for psoriasis work also for PsA although not always as efficient, but that is mostly dus to differences in persons. Medics often think that there is a difference in disease, but I really don't believe that to be true.

I am on DMF, that is working fine, I have hardly any trouble with it since the last 15 years, unfortunately DMF appears not to be available at your side of the ocean. Well... It is there, but as a medication for MS.

[mataribot]

Did you go through rheumatologist? If so you are better off wih dermatologist for Cosentyx. Dermatologist have their hands tied less.

[PAmerican]

I went to a top rheumie, and then got 2 second opinions from other rheumies. One of them said all of her patients are on Cosentyx and none pay, and looking at my chart from my original doc, my insurance was not going to approve it. She was right! Now he is handling the appeal and I don't trust him. He just goes too fast with lots of trusts me's and most of what I know I found out on my own. All he's been good for so far is the dx (which I am grateful for, I've had 5 related surgeries and no one ever said arthritis), and gabapentin rx- which doesn't work for me when I take it, maybe bc I take it at night and there's too much pain built up by then. I don't know why I bother, it's a wasted copay. My mom and grandmother died of Lupus/cancer related to treatments, my sister and aunt have Lupus, so I can't take TNFs. I won't take anything that requires liver function tests bc I already do that for another class of meds I take, and you only get one liver, and I'm not pushing it further. My mom's rheumie agreed that Cosentyx was the way to go. After much research, I finally get on board, and boom, not approved. Who knows how long appeals take? My rheumie said to call the insurance co everyday for a status update. As if anyone I would end up on the phone with would have any kind of sway in the matter! 

I found an internist (regular doc) in Montana (2 days drive, I ride the subway) that co-treats with diet and if needed, hormones. I'm getting my blood drawn for food allergies tomorrow. The test is about $300 and is not covered, and then I have to have the appt with the doctor to go over the results, which is also not covered. That's alternative medicine for ya. But I'll do it, bc I have it in both feet, both hands, both knees, both elbows, my lower back and this month starting on my upper left back and neck. Woohoo, just turned 40! I don't even have wrinkles yet!

I spent more than I made this week on doctors. All in a week's work.

[mataribot]

How about Stelara? I think there is small trial for lupus. Not sure the results - not complete yet. It maybe option for you and should be easier to approve.

[mataribot]

There is also Orencia - not approved for PsA but does work for it. This option will probably be harder than Stelara.

[PAmerican]

My insurance co will only allow TNF inhibitors or methotrexate for me, specifically, these were the grounds for denial. It's a private insurance co and they won't approve anything else until those are proven to fail. My doctor doesn't want me on the first (because of Lupus in my family, I don't have Lupus and I'm tested frequently), I don't want the second (I tax my liver enough with other drugs that cannot be replaced). If these are the grounds I don't see how coming up with other options is going to help at all. But I will look into all of them for research's sake, many thanks!

I don't know anything about appeals, how many you get. I think Cosentyx is up in 4 years here, then the arguments are moot, they won't have the corner. I had planned to get a better job in 1.5 years, but this is making me wonder what's more important. I wish I had a better doctor to plan this stuff out with. Anyway, 1.5 and 4 years are a long time to let this run its course. I was handicapped with my back all spring, and I always struggle with my feet. The rest I can live with.

So in all likelihood, I'm going to start this Otezla pack this weekend, have all the flu symptoms bc I am the commensurate 1% that gets them all, and then go through it for nothing bc that will be denied too.

It's just my entire body, no big deal. I see your point, Oxford United, I should definitely knock out my liver too before selecting a drug with my first, second, and third opinions. You know best. You are an insurance co after all. 

[mataribot]

Many people start with Stelara. As long as your insurance covers it. Just takes work from doctors to get approved.

[PAmerican]

Well, my appeal ends today. I will find out by 5pm EST about Cosentyx approval. It's that or Otezla, which was approved, but I am very concerned about the side effects, and it's a $75 copay and I have many other steep copays too.

I asked the insurance agent to wish me luck on my appeal and she wouldn't 

[Fred]

Well, my appeal ends today. I will find out by 5pm EST about Cosentyx approval. It's that or Otezla, which was approved, but I am very concerned about the side effects, and it's a $75 copay and I have many other steep copays too.

I asked the insurance agent to wish me luck on my appeal and she wouldn't 

I'll wish you luck.

Good luck.

[PAmerican]

I don't care what Trump says, muchos gracias amigo!