MS TREATMENT WHICH ONE DO I CHOOSE

[marymoto]

HI was wondering which type of med everyone is on avonex betaseron copaxone, or rebif and how are you doing on it has it slowed down your relapses?

[marymoto]

thanks everyone for the great responses looks like i will probably try the copaxone.

[Lulu54]

thanks for sharing some insight about how the Canadian drug plans work - that was very interesting.

[marymoto]

thanks mike take care and lets hope your mri comes out well this time.

[Mike_Shuswap]

I'm doing ok on the rebif, thanks for asking. Been on it for 8 months now. Still having some mild side effects, like headaches, but a couple tylenol extra strenth takes care of it most days.

For the first 6 months I got a blood test every month to check my liver, no problems, so now I just get tested every 6 months.

I'm heading down to UBC at the end of the month for an MRI, so I'll find out how my lesion are doing.

I don't think I've had a relapse since I've been on rebif, but I don't really know. I have good days, bad days, in between days. I'd have to get nailed pretty hard to recognize it as a relapse.

I think it was DV who mentioned you might not be prescribed an interferon because of previous liver issues, but if you are given rebif you'll be able to use the rebismart injector.
You don't even see the needle with this device.

Good luck with your appointment in April! I hope you and your Dr's come up with a plan.

mike

[marymoto]

thank you for all the greatinfo mike great to here from you.how are you doing on the rebif?

[Mike_Shuswap]

With special authority fair pharmacare will pay 70% when you reach your deductible and 100% when you reach your family maximum.

In my case pharmacare pays 70% when I hit $3000 deductible and 100% when i reach about $3800, on the drugs they cover. There are lots of drugs not covered by pharmacre, like Detrol la, tramacet, pantoloc, etc. Gabapenton is covered, and Rebif is covered by special authority, which is a good thing, as it costs almost $2000 a month.

Your pharmacy will only charge you the amount not covered by fair pharmacare.

Pharmacare will not pick up the 20% your husbands plan doesn't pay. Your extended medical plan has no bearing on what pharmacare will cover.

Most extended medical plans have a life time maximum, so it's important to have pharmacare pay all they are willing to.

Remember any medical expenses out of pocket are tax deductable in Canada, so keep all reciepts.

hope this answers your questions.

mike

[marymoto]

thanks for the great info i am registered for the pharmacare. it is based on your previuos two years of income tax.my husband has a plan that covers 80 percent i beleive it is so do you think pharmacare will pick up the rest. i know one lady i talk to said they ended up paying 300 per month. with the special authority do they pay the whole cost?

[doublevision1]

Thanks for jumping in Mike, the BC program is somewhat different from Alberta, and I believe Mary is in the lower mainland.  

For the Alberta program, you MS specialist has to do the application, and patients have to apply for Blue Cross Non-Group coverage, about $30 month (waived for low income), with a $30 monthly co-pay for the DMD.  For those who already have supplemental health coverage through a group plan (I do - wtih my employer), the plans are linked and in my case, fortunately eliminates the $30 co-pay.

[Mike_Shuswap]

You have to be signed up with 'FairPharmacare".

They calculate your deductable based on your income, and once you reach your deductable they pay 70%, till you reach a maximum, then they pay 100%.

They don't cover all drugs, there is a list of what's covered on their website. (I think it's through 'service BC')

Some drugs, like Rebif, can be covered by what they call 'special authority'. Your doctor has to send them the application.

All pharmacies in BC are connected to FairPharmacare by computer, so it's all automatic.

I hope this helps. Good luck with your choice.

Mike

[marymoto]

hi how does the provincially funded drug program work?

[Ojibajo]

Where did you read/hear that Avanex was less effective? Everything I read says the opposite. Do you have any links for me? I am planning on starting it on Thursday.

Amy

[Ojibajo]

I haven't started mine yet. My neuro appt is this Thursday, but I am hoping to try Avonex.

[doublevision1]

Given you say you have had liver issues in the past, you may not be a good candidate for the interferons.  As others here have stated, fortunately Copaxone is an alternative that does not pose a risk to elevating your liver enzymes.  Ensure your neurologist is aware you have had liver and thyroid issues in the past so together you can make a fully informed decision.

Another consideration with the interferons is a history of depression.  Your neuro should complete a depression screening to ascertain if the interferons may pose greater risk to you.  In Alberta this screening is a required component of the application process for the provinically funded MS Drug Treatment Program.  

Although I had no history of serious liver issues though did experience elevated enzymes during a bout of mono 20+ years ago, Rebif caused my enzymes to shoot up quickly.  I was on it for several weeks before deciding to stop, and since then have been on Copaxone for nearly 3 years.  No lasting side effects thus far and only one flare of ON since I have been on it.

[marymoto]

thanks ladies for the great posts have the meeting to discuss the different meds in april.hope i will be able to go on one with previous liver issues and thyroid problems.

[MsmsinFl]

hi Mary--

I was very lucky -- at my first neuro visit, we discussed CRABs, and he sent me hope with tons of info on all of them, as well as books about MS.  He recommended Rebif for me, but he also has patients on Copaxone.

I've been on Rebif 22mcg for 18 months -- no flu-y symptoms, no side effects (except a mild occasional morning-after headache).  No relapses.  I'm taking half of the usual 44mcg dose at my request -- I have a history of depression and thyroid problems, and I figure if I do well on the lower dose, that's best for me.  Neuro tells me it's not unusual for folks to stay on the 22mcg dose.

I'm pretty thin, and my neuro felt I'd have problems with daily injections (Copaxone) -- he says he sees lots of tissue breakdown in more-frequent injections;  I knew I'd hate the Loong  Avonex needle, if only weekly -- plus Avonex is less effective than Rebif, although it's the same basic med.  Betaseron wasn't really suggested to me.

I will say that in my experience, FAT is your friend with the injectables -- so if you have little fat, the less-frequent injections might be better for you.

And whatever you start with, if it doesn't work out for you, you can always change to a different med.
  
Best of luck as you start this journey -- it's pretty overwhelming at first, but the shots do get easier very quickly.  There's tons of info here on how to make the injections easier.

[anon07072023]

I chose Copaxone and I've been on it for almost 6 months. I think that it's too soon to tell if it's working. They say maybe after about 7 months of taking it, it will be at it's full power (I think).
Copaxone is very expensive, but my insurance pays just about all of it, and Shared Solutions pays the rest. It works out to about $3700/month.  I don't know what the cost of the other DMDs are.

My neuro wanted me to try Copaxone first. It doesn't have interferon, so there's no flu-like symptoms associated with it. And it doesn't require you to have your liver tested periodically. (Although, I can't really speak for all the other DMDs since I've never taken them).

I guess it's a discussion you need to have with your neuro and those in your life that you feel should be involved in the decision.

Best of luck,
Kelly

[sllowe]

Hi Mary,

Welcome back! Did you get a dx?

I bumped the DMD User discussion so you can take a look at that.. Rebif is serving me well - no major relapses or major increase in lesion load.

Spill your update if you can!
-shell

[Lulu54]

Hi Mary - are you faced with making a choice?  My MSologist calls it the pepsi/coke challenge.  All of these drugs work at about the same rate of efficiency - it is a matter of personal preference which way we want to administer the drug.

best,
Lulu

PS I'm on copaxone and it seems to be working.