[jprinz99]

Going in to neuro next month to "get started on a med" (i.e. CRABs, etc)

I called my Medicare Advantage plan's patient advocate that is assigned to me. Nice lady, helpful. She said they don't approve copaxone or avonex unless I can't take others. So my choices are the others. Also learned the ins co "process" requires the neuro to get authorization first from my ins co (Anthem BC/BS Med Pref Premium PPO- Virginia plan). Also learned those of us with Medicare are now having tougher time getting drug companies provide drugs free/low cost due to the laws passed (thank you politicians & pharmaceutical companies...)

Seeking advise on pros/cons of the rest of drugs

Also how do any of you (at least who get Soc Sec and have an advantage plan) afford this stuff??? From what I have been digging up I may not even need to choose a drug- as I cant afford the "specialty tier" 33% copays!!!

sigh- just as I get ready to fight back this monster, I find I may be unarmed

[ANNagain]

Jane,

I am sorry that you are limited in your choice. I thought the government was changing the rules to get insurance companies out of making medical decisions but here it sounds like the government is deciding that you can't have Copaxone. Yet.

I did well on Avonex except for the weekend flu. It worked for me. I got 1 new lesion at the end of 5 years and no exacerbations. Then I went to Rebif and got depressed (side effect of interferons). Now happy on Copaxone.

Massachusetts is working to change a law so we can use coupons and discounts from drug companies- it may have already passed.

ANN

[Dejibo]

copaxone just came out with a promise that no one shall pay more than a $35 co pay per month who takes their drug. Since you need to fail off another one first (which is just wrong) you will have to try Avonex (which now has a small needled, auto injector, and is once a week) or Rebif (3x a week) or Betaseron (every other day) All have about the same side effects.

You wont know which way it will affect YOU till YOU take it. I didnt react well, but my friend has been on it 10 years without a single issue.

[jprinz99]

I got so excited about 35 dollar copay program until this:
(copied from their site)

Terms and Conditions: COPAXONE Co-pay Solutions™ is open to both new and existing patients who are residents of the US or Puerto Rico and who have private insurance coverage. The offer is not valid for patients covered in whole or in part by Medicaid, Medicare, TRICARE, or any other federal or state government pharmaceutical assistance plan or program (regardless of whether a specific prescription is covered), or by private health benefit programs that reimburse for the entire cost of prescription drugs. Use of this offer must be consistent with the terms of any drug benefit provided by a health insurer, health plan, or private third-party payor. This offer is void in Massachusetts or where otherwise prohibited by law, taxed, or restricted. No additional purchase is required. This offer is valid only at participating pharmacies and may be changed or discontinued at any time without notice. This program is not health insurance.

I wonder if this means me since I have a M.A.P.

[KittyLady]

Great! If I read correctly, I will be dealing with this dmd nightmare in 1 1/2 yrs. Im on ssdi right now but wont qualify for medicare for another 1 1/2yrs. I pay nothing now as I dont have any health insurance and our income is low. I guess maybe my copaxone friend will be leaving me then. This was the last dmd I was willing to try. Well, I went 10 yrs w/o a dmd, I can do it again

[Shadiyah]

I am just reading this thread and I wanted to know if this medication will cost me a lot of money.

[ginnie]

Yes, I have had issues getting medication too. Glad we can talk about this here on NT. I wrote 8 begging letters to a medicare part D provider last year. Got disgusted that so many were denied to me. Changed the proveder this last december. The interviewer went over all my medications and said they were all covered. Got my new formulary, guess what, two arn't on it. So did they just lie to me to get me to sign up???????????????????????.
I think alot of folks are getting turned down for medications. Mine was for asthma, an inhaler, and singular. Both cost a fortune. I wonder how many others are having trouble getting meds. Sorry this happens to you too. ginnie