Good Evening, What follows is a detailed description of how one cannot confirm the cost of Humira, costing me $1,600 out of pocket. Spring 2017 Knowing I was to step down from earning income to pursue an unpaid internship that would start in June 2017 I began planning a head. I first contacted my rheumatologist (Whom I've been working with at this point for over one year) for an annual checkup to continue Humira which I had been prescribed for nearly one year at the time. The appointment was made. During this appointment it was discussed how the Humira appeared to be wearing off before the next dose was to be administered and the concept of increasing the dose frequency to three times per month was suggested by the Dr. The Dr. then stated that working with the insurances can be "tricky" in order to get this increase per-authorized.
Within a few weeks my Dr. called me and confirmed the approved per-authorization for the administration of three Humira pens per month instead of just two which was the original prescription. I then call my "Humira Complete Savings Card" to discuss how the co-pay assistance would influence the moving forward with this new prescription. Keep in mind the is early Spring of 2017. The co-pay assistance staff stated that until there is a charge due to the dispensing of the prescription they would be unable to know whether or not the co-pay assistance would fully cover the new prescription.
Up to this point the co-pay assistance was able to cover all but $10 of the cost of my two doses of Humira per month. I then called my rheumatologist and the nursing staff who directly worked with my Dr., after discussing it with the Dr., suggested that it was up to me to move forward with the new prescription due to their lack of insight on how much if any I would be charged for the medication. This was alarming to me so I then called my insurance and they also confirmed that until there is a charge for the new prescription (which means I would have to agree to receive this medication WITHOUT anyone who should know to be able to tell me how much I would personally be responsible for) they will not be able to tell me how much it would for me to move forward. My Rheumatologist then encouraged me to move forward with the new prescription adjustment and they will do their best to aid me in finding charities of co-pay assistance foundations that would help me with any out of pocket expense not covered by insurance and co-pay assistance.
After roughly four months of preparation for me to A) get a prescription adjustment and B) begin coverage on my wife's insurance in June (which was set up flawlessly) I decided to move forward with the new prescription. This is where it gets interesting don't miss this... Promptly, as before, I received my June doses of Humira but instead of the prescribed three doses I received four doses...not thinking anything of it I administer my scheduled dosing a prescribed by my Rheumatologist and while ordering my following months prescription I was informed by my insurance that I now have a $2,381.11 bill that is due before the next months medication can be released... "Uhh What!?!" I stated to my insurance who then stated that if I were to reach out to my co-pay assistance card they might be able to release an "extended benefit" which might decrease much of the current bill. Following their direction I reached out to my co-pay assistance and they were able to release $700 in extended benefit toward my bill, which I am very thankful for. Now I somehow have an even $1,600 bill that my insurance is sticking me with.
I then discovered that many of the charity foundations that aid in this matter only aid if the costs are predetermined and these foundations want every bit of financial information from the patient (Which is understandable). At this point I did not pursue any foundation financial aid and I began the appeals process immediately. In August of 2017, after the second appeal was denied and after extensive conversation with my rheumatologist about the financial cost I am now bearing, he suggested I reach out to Abbvie (Pharmacy Solutions) about the cost AND inquire as to why I received four doses of Humira instead of the prescribed three.
It gets even better now... What was stated by the Abbvie / Pharmacy Solutions employee is that and I quote, "The FDA has regulated the dosing of Humira to the dispensation of two doses at a time. Unless there is a manufacture warranty claim (Bad/Faulty Pen) Pharmacy Solutions because of the warranty claim may dispense one dose at a time the FDA will only allow two Humira doses to be dispensed regardless of prescription."
So in a nutshell my insurance was then charged for the extra dose without consent from my Rheumatologist and I got stuck with making up the financial cost difference of $1,600. Meanwhile, my wife and I are down to one income because of starting my unpaid internship, our HSA does not have enough to cover this cost, and we get pregnant (which I am very thankful for). Today (Late December, 2017) I again called my insurance company, because of this remaining $1,600 bill (that I at this point am reluctant to pay due to the complete circus show of being stuck with this bill regardless of how much effort was put into "Putting my ducks in order") and my wife is being prevented to purchase her Asthma medication due to our account being "locked" because of this now "Over sixty day past-due charge of $1,600."
Being completely fed up I paid the $1,600 because our HSA finally had enough in it. Everyone watch out, this drug (Humira) will cost one person's insurance annually tens of thousands of dollars per year when to drug is manufactured in the Dominican Republic I believe (Via my Rheumatologist who visited the manufacturing facility of Humira who told me about this) which then literally cost less than twenty-five cents per dose is being sold for well over $1,000 per dose in the USA... Please (Scoff)... Pharmacy Solutions and whoever else is in on this scam, your lack of integrity is well noticed. Sure, I'd like to be compensated for this but my wife and I are finally done with this Bull-sh*. I hope Pharmacy Solutions gets a wake up call when the insurances all stop paying for this medication and when the government wakes up to the loop-hole of how Pharmacy solutions keeps pushing out the "patent end date" by purposefully instituting "New Treatments" for this medication to be used for which prevents an generic from getting a hold of this "Wonder Drug." I hope that the people who genuinely need this medication can get it for a reasonable cost and not get sucked into the Bull-s**t of insurance scamming from companies like Abbvie. This whole thing is exhausting and discouraging, especially for someone just trying to prevent their spine from fusing together... I Say "Good Day." Today I am no longer on Humira or any medication for my Ankleosing Spondilytis...
Pharmacy Solutions Reviews
Good Evening, What follows is a detailed description of how one cannot confirm the cost of Humira, costing me $1,600 out of pocket. Spring 2017 Knowing I was to step down from earning income to pursue an unpaid internship that would start in June 2017 I began planning a head. I first contacted my rheumatologist (Whom I've been working with at this point for over one year) for an annual checkup to continue Humira which I had been prescribed for nearly one year at the time. The appointment was made. During this appointment it was discussed how the Humira appeared to be wearing off before the next dose was to be administered and the concept of increasing the dose frequency to three times per month was suggested by the Dr. The Dr. then stated that working with the insurances can be "tricky" in order to get this increase per-authorized.
Within a few weeks my Dr. called me and confirmed the approved per-authorization for the administration of three Humira pens per month instead of just two which was the original prescription. I then call my "Humira Complete Savings Card" to discuss how the co-pay assistance would influence the moving forward with this new prescription. Keep in mind the is early Spring of 2017. The co-pay assistance staff stated that until there is a charge due to the dispensing of the prescription they would be unable to know whether or not the co-pay assistance would fully cover the new prescription.
Up to this point the co-pay assistance was able to cover all but $10 of the cost of my two doses of Humira per month. I then called my rheumatologist and the nursing staff who directly worked with my Dr., after discussing it with the Dr., suggested that it was up to me to move forward with the new prescription due to their lack of insight on how much if any I would be charged for the medication. This was alarming to me so I then called my insurance and they also confirmed that until there is a charge for the new prescription (which means I would have to agree to receive this medication WITHOUT anyone who should know to be able to tell me how much I would personally be responsible for) they will not be able to tell me how much it would for me to move forward. My Rheumatologist then encouraged me to move forward with the new prescription adjustment and they will do their best to aid me in finding charities of co-pay assistance foundations that would help me with any out of pocket expense not covered by insurance and co-pay assistance.
After roughly four months of preparation for me to A) get a prescription adjustment and B) begin coverage on my wife's insurance in June (which was set up flawlessly) I decided to move forward with the new prescription. This is where it gets interesting don't miss this... Promptly, as before, I received my June doses of Humira but instead of the prescribed three doses I received four doses...not thinking anything of it I administer my scheduled dosing a prescribed by my Rheumatologist and while ordering my following months prescription I was informed by my insurance that I now have a $2,381.11 bill that is due before the next months medication can be released... "Uhh What!?!" I stated to my insurance who then stated that if I were to reach out to my co-pay assistance card they might be able to release an "extended benefit" which might decrease much of the current bill. Following their direction I reached out to my co-pay assistance and they were able to release $700 in extended benefit toward my bill, which I am very thankful for. Now I somehow have an even $1,600 bill that my insurance is sticking me with.
I then discovered that many of the charity foundations that aid in this matter only aid if the costs are predetermined and these foundations want every bit of financial information from the patient (Which is understandable). At this point I did not pursue any foundation financial aid and I began the appeals process immediately. In August of 2017, after the second appeal was denied and after extensive conversation with my rheumatologist about the financial cost I am now bearing, he suggested I reach out to Abbvie (Pharmacy Solutions) about the cost AND inquire as to why I received four doses of Humira instead of the prescribed three.
It gets even better now... What was stated by the Abbvie / Pharmacy Solutions employee is that and I quote, "The FDA has regulated the dosing of Humira to the dispensation of two doses at a time. Unless there is a manufacture warranty claim (Bad/Faulty Pen) Pharmacy Solutions because of the warranty claim may dispense one dose at a time the FDA will only allow two Humira doses to be dispensed regardless of prescription."
So in a nutshell my insurance was then charged for the extra dose without consent from my Rheumatologist and I got stuck with making up the financial cost difference of $1,600. Meanwhile, my wife and I are down to one income because of starting my unpaid internship, our HSA does not have enough to cover this cost, and we get pregnant (which I am very thankful for). Today (Late December, 2017) I again called my insurance company, because of this remaining $1,600 bill (that I at this point am reluctant to pay due to the complete circus show of being stuck with this bill regardless of how much effort was put into "Putting my ducks in order") and my wife is being prevented to purchase her Asthma medication due to our account being "locked" because of this now "Over sixty day past-due charge of $1,600."
Being completely fed up I paid the $1,600 because our HSA finally had enough in it. Everyone watch out, this drug (Humira) will cost one person's insurance annually tens of thousands of dollars per year when to drug is manufactured in the Dominican Republic I believe (Via my Rheumatologist who visited the manufacturing facility of Humira who told me about this) which then literally cost less than twenty-five cents per dose is being sold for well over $1,000 per dose in the USA... Please (Scoff)... Pharmacy Solutions and whoever else is in on this scam, your lack of integrity is well noticed. Sure, I'd like to be compensated for this but my wife and I are finally done with this Bull-sh*. I hope Pharmacy Solutions gets a wake up call when the insurances all stop paying for this medication and when the government wakes up to the loop-hole of how Pharmacy solutions keeps pushing out the "patent end date" by purposefully instituting "New Treatments" for this medication to be used for which prevents an generic from getting a hold of this "Wonder Drug." I hope that the people who genuinely need this medication can get it for a reasonable cost and not get sucked into the Bull-s**t of insurance scamming from companies like Abbvie. This whole thing is exhausting and discouraging, especially for someone just trying to prevent their spine from fusing together... I Say "Good Day." Today I am no longer on Humira or any medication for my Ankleosing Spondilytis...