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NRAS
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Cost Of Humira

Hi folks. I got diagnosed with Ra in 2007 and my rheumatologist put me on prednisome, metrotrexate and humira. I was finally getting along so good that I asked my doctor whether we could try it without the humira (which I was getting free as I had no insurance). Well recently due to the excrutiating pain I'm feeling in my groins, I've asked her to try putting me back on the humira. I now have insurance thru my workplace that cost me nearly $400.00 a month and am waiting to see if they (insurance) approve the humira. I've done some research on line and found out that with a drug discount card the humira cost over $4900.00 a month (that's 2 shots) and since it is tier 4 drug my co-pay is 25%. Has anyone run into this problem, and if so, do you have any suggestions. I must make too much money to get any assistance from where I've been looking. Open for suggestions.....

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In the UK you pay a set amount for a prescription if you are under 60 and not on benefits. To have biologics you have to meet certain tight criteria but it doesn't cost you more. I guess you are in the US which has a very different system, so you may have to wait for a USA poster for suggestions, but I hope you get it sorted.

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Well I'm in the UK and having to pay £1100 per 28 days for it. Not on Nhs for me. Insurance won't pay in uk

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Eek! I know private insurance in UK won't cover it, and NHS get it at a special rate. Out of curiosity, is it easier to get prescribed privately or do you have the same NICE guidance strictly applied?

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the same guidelines exactly but I've been with my rheumy for a long time. I will have to move to NHS though as too expensive.

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Does your Rheum work in the NHS too? I understand private allows continuity of Consultant that you trust and you could get stuck with a good, hopeless, or something in-between Reg in the NHS. Tricky! I think there was hope that the new meds 'nibs would be cheaper as they are tablets, but they aren't. I guess drug companies try to recoup money spent on research, and some.

NHS sometimes gets bad press, but OHs clinic is very friendly. He's only 9 mths since diagnosis so sees Nurse regularly, has blood done by Rheum HCA etc. Not all runs smoothly. Found himself in Rapid Access Clinic on Lupus day which appeared to be an Admin area. Priv sector hasn't been any better though.

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I'm sorry, I get confused by these abbreviations that are used. What does NHS and NICE mean.

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Sorry! In the UK the NHS is National Health Service which is free to everybody and includes GPs and hospitals. Some people also have private insurance from their company and pay a proportion of Consultation and treatment. Some go privately and pay everything. The private route usually involves seeing an NHS doctor, but in a private clinic or hospital. NICE is National Institute of Clinical Evidence. They review standards of care and treatments and decide criteria for them. Ie in the case of RA they set tight restrictions on prescribing biologics. I hope thats clearer. It doesn't help your situation any unfortunately!

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Thanks so much Norisa. I'm in the USA so that's why these abbreviations are unknown to me.

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Any questions just ask away. I'm sorry we can't help on the USA situation.

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Oh thanks so much Norisa. I'm still investigating.

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and what is OHS?

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It's OHs... Other Halfs as in partner.

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Ah! Thanks for the answer. Here in US we call them SO for significant other!

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You'll probably find a few abbreviations differ from yours with it being a UK site. I have an American friend who ages into our friendship said how she loved my English sayings. It made me wonder how the heck she knew what I was talking about at times & she said she looked them up on google! Couldn't work out why she didn't just ask. 🤔

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nomoreheels, I love them too! I have a few friends in the UK and I am learning and better understanding the sayings over the years. :)

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I prefer OS as thats much more accurate.

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Hattie that's horrendous! Defoe go back to NHS if you can. Alternatively there is a Humira biosimilar that is less expensive I believe.

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Yes it's about to be on market but not yet. I'm probably coming off this for a bit anyway as need surgery....

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Good luck with the surgery X

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Thank you so much x

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In the UK most health trusts are switching patients over to biosimilars* where possible in order to save money, do you know if there's a biosimilar to Humira available in the US?

(*biosimilars are the same drug made by different companies once the patent has expired, always cheaper than the original)

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I was on Humira for a little over a year with private insurance in the U.S. and used the Humira Savings card and was able to get my copay reduced to only $5 a month. See humira.com/humira-complete/... Have you looked into this yet?

Hope this helps!

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OMG! I'm looking into this right now. Waiting for a nurse ambassador to call me. Thank you so much for the link. I'll let you know what happens.

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I am in USA and i have enbrel:) so almost same price, i have insurance and medication is cost me 35$ per shot. Was kind of hard to get approved by insurance but my doctor was helping me:)

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I will talk to my rheaumy about embrel. Thank you.

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