months, but found it difficult to manage its immunosuppressant side effects
— I had a constant cold. When I asked my physician how to avoid getting
sick, he recommended that I avoid crowds. This was not an option, and I
searched for a new form of treatment.
Since 2002, I have tried and failed the biologics Xeljanz, Humira, Kineret,
and Enbrel. My insurance refused to cover a prescription for the biologic
Cimzia. In July 2016, I restarted Humira, a medication I first took in 2006. I
hoped that it would work more effectively on my thirty-six-year-old body
than it did for me at twenty-six. Right away, I knew that Humira was not
working. However, my physician insisted on keeping me on Humira for six
months to see if it might eventually work. During those six months, my knees
were permanently swollen, and I used a cane to help with even the shortest
walks. My left elbow was swollen and limited in its range of motion, affecting
my ability to shower and get dressed. To combat the pain and swelling, I was
placed on twenty milligrams of prednisone, which caused insomnia and
weight gain. In December 2015, my physician finally concluded that Humira
was not working and agreed to let me try Remicade again. The doctor’s nurse
stated that unless I qualified for a prescription assistance plan, I would be
responsible for twenty percent of Remicade’s $8,700 per infusion cost.
first two infusions would be scheduled two weeks apart, and then I would
receive the medication monthly. As a result, I faced approximately $23,000
in unexpected yearly out-of-pocket medical costs. However, with access to a
Remicade biosimilar, I can benefit from Remicade, yet pay a fraction of the
biologic’s current cost. Biosimilars often sound like the financial miracle I
have been waiting for.
In 2013, I began to chronicle my experiences as an RA patient in a blog I
wrote for the online patient community Creaky Joints, a website managed by
the Global Healthy Living Foundation (GHLF).
32 Through GHLF, I became
involved in lobbying efforts surrounding biosimilar legislation. In 2015, I
testified in support of legislation ultimately passed in Louisiana, which
31. Jeffrey R. Curtis et al., Cost and Effectiveness of Biologics for Rheumatoid Arthritis
in a Commercially Insured Population, 21 J. MANAGED CARE & SPECIALTY PHARMACY 318,
326 (2015) (noting the average administration cost of Remicade (Infliximab) was $1,888 for
commercially insured individual). In the author’s experience, a Remicade infusion involves
the following costs: price of the biologic itself; pre-infusion steroid and pain relief medication;
and costs associated with an out-patient surgical procedure, including IV insertion and
monitoring of patient vitals. I have been informed by the hospital that administers my
Remicade that the cost of the medication is around $8,700, exclusive of the additional costs
related to infusing the drug. There are, of course, other costs—the lost wages caused by a
three-hour infusion and its side effects, as well as the physical pain caused by insertion of a
large needle that remains in a patient’s vein for around three hours.
32. Kat Macfarlane: Articles, GLOBAL HEALTHY LIVING FOUND.: CREAKY JOINTS,
https://creakyjoints.org/author/katmacfarlane/ (last visited Apr. 9, 2017) (collection of
eighteen essays written for CREAKY JOINTS).