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288459 tn?1201291329

diagnosis that i cant afford

I would like to start by saying that the people in this forum are greatly appreciated for their help and vast knowledge of very complex illness. I had my final follow up at my neuro today. After all of my testing I was told today that my issues are being caused by ms. They are trying to schedule me with a MS specialist. As you are all aware that willprobably take some time. However, he doesnt feel that I should wait to start Avonex. They are scheduling a visiting nurse to show me how to take these shots.  In the meantime ( I hate to sound blunt) but how on earth do they expect a working class person to afford that? I called my pharmacy and they told me the cost per month is 2200.00. Which means 550.00 to me..... I was in shock. So, I guess my question would be, are there alternatives? possibly a similar medicine that any of you are or have taken that may be less of a hit financially? They gave me another book today and there were like 5 or 6 different medicines in there, but they didnt even discuss any of the others. ( I am not sure why) . I do know my health is very important and I do take it seriously however I hope someone can understand my thoughts. Or maybe I am just approaching this all wrong..... thanks again for any help... I hope this post finds everyone doing well! take care,    Kim
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288459 tn?1201291329
Thanks so much for taking your time for me & my new found adventure. Quix you hit my worry button right on the head. As far as the whole income thing.... I believe will be in the same boat. I will just have to see what they count as far as outgoing expenses. But all ya can do is go with it and do what ya can do. ( I think thats my new motto). Yep this broad definitely needs a squad to join!!!  Count me in....I will be in charge of the snack department.... lol have a wonderful day all & thanks again!!! (I am truly thankful that I found this forum!)
Helpful - 0
147426 tn?1317265632
As you may know, I have been on Avonex for 8 months almost now.  My income is too high to qualify for the aid, but they (companies, clinics and MS society) will not let someone go without for inability to pay.  Keep checking all those sources you've been given.  It will work out!  I'll join the broad squad.  I get to be the broadest!

Quix
Helpful - 0
Avatar universal
All of the above advice is right on.  There is assistance.  Stay on the forum and tell us how it is going.  I will be starting Copaxone in a week or so and my co-pay is probably about $150.00 per month.  It's alot (not as much as $550. though) but I am blessed and we can afford it.  Heather is also starting a treatment soon as well.  Lets be "The Broad Squad" and all go through it together.    God bless you,  Amy
Helpful - 0
164435 tn?1377102256
VERY SORRY TO HEAR ABOUT YOUR DX.
I WAS DX IN MAY ALSO, IT IS ALOT TO TAKE.
I AM STILL IN DENIAL. ANYWAY I DO NOT TAKE SHOTS.
I DO TAKE OTHER MEDS FOR MY PAIN AND TREMORS.
IT IS UP TO YOU TO MAKE THE RITE
CHOOSE. READ UP ON YOUR OPTIONS.
GOD BLESS  KITT
Helpful - 0
288459 tn?1201291329
thanks so much for all of the great info you have given me. I will go to work immediately on some of these ideas that you have presented me with. I thank you all for being so helpful i understand that we all have issues to handle and i feel so awful to say that I have not been very self sufficient.However, I  do intend on catching up on much reading in this forum and on similar websites. Thanks so much again to all of all. I truly am grateful! take care all and I will definitely let you know how I make out. Although it sounds like it may take some time! Again thanks & God Bless you     KIm
Helpful - 0
382218 tn?1341181487
I'm sorry about your diagnosis.  I hope you stay connected to this forum.  It has helped me enormously since my diagnosis 3 months ago.  The panic and fear will get better with time.  I never thought it would, but things do settle down after a while.  I hope you are able to surround yourself with supportive people; this makes all the difference.

I'm also sorry for the burden this may place on you financially, and like the others here, really encourage you to cut through the red tape of financial assistance.  Perhaps your local MS group can help with this and maybe even have a patient advocacy resource, someone to help you find your way through the bureaucracy.

I'm astonished that some people go broke trying to stay well, or are forced to go without treatment because they can't afford it.  I really do hope that whoever is elected your next president will make strides in this area and ensure that all Americans are guaranteed health care as a basic right.  

db1
Helpful - 0
373367 tn?1246402035
I  found this on avonex.com  (if you haven't already found it yourself)  

I would call and ask if they help w/high copayments, like yours.  If not, your city may offer assistance through some kind of "action committee" program.  It's just not right when people are having to make "house payments" just to stay well--and WITH INSURANCE  at that!!

Stacey

Paying for your AVONEX

We know that dealing with insurance companies for medication reimbursement can be difficult. And understanding Medicare benefits can be overwhelming. We're here to make it easier and less confusing. We have reimbursement specialists waiting to help you. Call AVONEX Services at 1.800.456.2255 to learn more.
Our specialists can help you with any questions about your health insurance plan and your percentage of coverage, as well as assist in "prior-authorization." They can also assist with claims denials, and find other sources of support for which you may qualify, including the AVONEX Access Program, which provides support to qualified uninsured patients. You don't need to have a prescription for AVONEX to call us.
If you have limited financial resources, you may be eligible for assistance. For more information, call 1.800.456.2255.
Most insurance plans currently provide coverage for AVONEX. The percentage of cost paid by your insurance company will depend on your individual benefits. You should review your individual insurance coverage for a better understanding of what, if any, limitations there may be on your particular insurance policy.
Helpful - 0
220917 tn?1309784481
Hey, Kim~

Sorry to hear your news.  What a lot to handle.  Ess is absolutely right about the drug companies offering programs to help subsidize the cost of the drugs for those that can't afford them.  550 is an awful lot of money each month!  

Please don't NOT take it just because it's hard to find out about the programs.  Ask at your doc's office, or contact the drug company directly.  When Quix is feeling up to it, and back on, ask her.  I know she's helped others look for help.  She knows where.

Hang tough!

Zilla*
Helpful - 0
Avatar universal
Hi,

I am sorry about your dx, but it is not the end of the world, even though sometimes we fee that it is.

I went back a little into the forum and got a post that I wrote at the begining of this year, which I think may be useful in your particular case.  Please I hope you do not feel offended with the information I will past and with my intentions to help you.

It goes like this:

I have been on Avonex for the past 3 years and my biggest copayment was $12.00 a month, now it is $8.00.  I have Blue Cross and Blue Shield from the Federal Government, my employer.  If I had to pay all my medications out of my pocket I would not be able to afford it because it would be around $4,000 a month.

I remember when my good neuro first prescribed Avonex.  She faxed it to Biogen, the pharmaceutical that developed it, and in less than 3 hours, its representative was teaching me  how to self inject and also everything that I should know about the medication.  On that same day, a caseworker called me to explained the side effects, how to handle any issues that may arise through the course of the treatment, their customer service which is excellent.  I was called again my a Biogen representative, by the way because I am in Puerto Rico they thought that I may need a translator and they had one in each call, a representative from my insurance company and myself to discuss what would my insurance cover, what my copayment would be and if there was a max amount in the year, because they needed to provide me with medication no matter the cost.

The Avonex lady could not believe that my copayment was so low, but she told me that if my circumstances change to let them know immediately because they have sponsors who would help me out with funds to cover my medication.

My reccomendation is to call the manufacturer and ask if they have sponsorship programs or at least explain your predicament to them, they may the solution to your problems.

I am not saying that Avonex is the best of all the MS ABC drugs and I am just mentioning my experiencing with it.

I hope I was of some help to you.

You are just a message away.  Remember we have MS, but MS does not have us!!!!!!!!!!!

Zulma (Gooddays)

Helpful - 0
Avatar universal
I guess it's good news/bad news for you and I understand that. At least you now have a diagnosis.

Why not take a bit of time and review info about all of the disease modifiers. Is there a particular reason to be on Avonex? The drug companies have programs to pay or help pay when the patient can't afford it, so please look into that with each manufacturer. It will probably involve a lot of red tape but will be worth it ultimately.

Of course it's important for you to be on meds, but a couple of weeks won't matter while you research all the alternatives. If you have info on all the drug choices, then check their Web sites and find out about financial aid.  Good luck to you.

ess
Helpful - 0
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