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Crohn's Disease Forum » Treatment » Remicade/Infliximab » Decision between Remicade and Humira


11-01-2009, 02:11 PM   #1
bubazoo
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decision between Remicade and Humira

for patients and doctors out there
What do you guys think?

For general care of our Crohns, which do you guys think is better to go with?
Humira? or Remicade?

I was on Remicade once about 3 years ago, but they took me off of it
after 12 months, because the GI doctor said, he heard there was a risk of getting Cancer for patients who are on imuran with Remicade over 12 months.

I don't know if thats true or not, but thats what that particular GI told me. I'm not here to judge one way or the other, just stating the fact here...

As I recall, I was on 5cc's of Remicade every 6 weeks, for 12 months, this was around 3 maybe 4 years ago, I can't remember for sure.

The first question I wondered about, they say your body forms antibodies against the Remicade drug after so long, if thats the case, would Remicade not be effective for me now?

Also, I'm unemployed, on (SSD) so my insurance is Medicare. They say I don't qualify for Medicaid, because I'm getting Medicare, which I don't think is right but thats what they keep telling me. I have to pay my medicare premiums out of my own pocket, just over $100 a month, because according to Medicaid, I get too much on SSD for them to cover my Medicare premiums. I still say $904.50 is hardly too much, especially since after those expenses, my net income is only $768.50, and since my apartment rental is $529 monthly alone, that doesn't leave me much to live on at all. Really sucks but what can you do, ya know? I'm totally blind, so its not like I can goto the local grocery store and stock shelves. lol I gotta find a job a blind person can do, which takes time. I'm not giving up, but my point being, I can't just get a job at a local fast food or walmart, I gotta find a job a blind person can do, which isn't always easy in this economy.

The reason I bring all that up, taking all that into account, wouldn't Remicade be an expensive choice? I mean, with those shots being $10 grand a piece, even if Medicare did cover 80% of it, 20% of 12-13 grand is still a big chunck of change every month, especially for someone who is unemployed, am I right?

So....taking that into account, wouldn't you think Humira might be a better choice? but then that raises another question, how much cheaper is Humira vs Remicade? I do have Medicare part D coverage thru AdvantraRX, and since its November now, I do have the option of switching to someone who does cover Humira, if AdvanceRX doesn't, so its something to consider, don't you guys think?

I know I should talk about these things with my GI doctor, but so far, he's not being very helpful in this particular situation. He just ays "well its up to you". Why is it up to me? Am I not the patient who is supposed to do what my doctor tells me? As patients, we can't make a sound decision about something like that without all the facts, so I guess I'm here to ask and to do research for myself with the help of my peers, otherwise I don't know whats best to do?

I think the GI's are wanting me to have an illeostomy, although they don't say it directly, while the surgeons keep saying "no he's not ready for an illeostomy yet. Yeah eventually, but not right now". Right now the surgery they have done has fixed the fistula problems, so they keep telling me I don't need an illeostomy, which I agree completely with, I think an illeostomy is way overkill, and will be causing me more grief more problems messing around with those stupid bags sooner then I have to, I agree with my surgeon on that, so now they want me to go all the way to Indianapolis for better care, when the doctors there are saying the same thing my surgeon keeps saying, that "well I can give you an illeostomy or Remicade or Humira, its up to you". Thats it, so here I am, a blind patient, who can't drive 3 hours down to Indy to have Remicade shots in the first place, I'm single and I live alone, and I just don't have transportaion like that at my disposal, so I guess I don't understand why the GI can't just make that determination for me? Remicade or Humira?

I understand you guys can't make my decisions for me either, but what are the facts before I jump with both feet into this? Have I probably formed antibodies against Remicade? is Humira really cheaper? what do you guys think?
__________________
CD 12yrs, went off SCD after 6yrs too expensive, imuran 50mg/2day, thinking about Remicade again after on it 12mo 3 yrs ago, have all internal parts still besides appendix. diseased illeum, 9 diseased areas in large, narrowing where colon meets rectum, and severe Rectal Fistulas in the spincter muscle area where hemorrhoids normally are.
11-01-2009, 02:22 PM   #2
Jennjenn
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I am sorry to hear that they cannot help you get medicaid for your supplemental insurance. I have tried Humira in the past and remember them telling me that it was $700 per shot. I did have insurance with my past employer though during that time. I dont know if that is still the case ($700) but there are programs through Abbott to help you pay for the shots for Humira for what the insurance will not cover. I am currently on Medicare also but I get the Remicade infusions.
11-01-2009, 02:27 PM   #3
bubazoo
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Before you guys answer this, I must say,
I'm quite thankful for my current surgeon, he was able to fix the Fistula problem in 1 surgery, that the other surgeon couldn't do after 6 surgeries, so I am quite thankful for that so at least my rectal pain is finally gone now. Pretty soon no more sitting on rubber doughnut wherever I go! woohoo!!!

so I am thankful for that.....

but they are right, even though the Fistulas are finally gone for the moment anyway, I still have to decide on a treatment for my crohns in general.

I mean, like my surgeon said, the Fistulas could always come back, the large intestines and small intestines could always get worse, ya never know, so even though I'm thankful for the main problem being gone, I still have 9 bad areas in the large, a bad illeum, and narrowing to deal with.

Another interesting note, my old GI from several years ago, asked me if I ever had an ostomy before, because he noticed an abnormal connection between the small and large intestines. I asked my family doctor about that, and he said "yes thats where the appendix normally is". I guess my old GI didn't know that I had my appendix out, they still say its a bad connection.

My mom was wondering, I had my appendix removed before I was diagnosed with crohns, would this abnormal connection where the appendix used to be, have anything to do with all these Crohns related problems? I didn't think it would, but my mom was wondering.
11-01-2009, 02:29 PM   #4
bubazoo
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Jennjenn said:
I am sorry to hear that they cannot help you get medicaid for your supplemental insurance. I have tried Humira in the past and remember them telling me that it was $700 per shot. I did have insurance with my past employer though during that time. I dont know if that is still the case ($700) but there are programs through Abbott to help you pay for the shots for Humira for what the insurance will not cover. I am currently on Medicare also but I get the Remicade infusions.
Hi JennJenn,

how much does Medicare cover of the Remicade infusions? do you know?
11-01-2009, 02:33 PM   #5
Jennjenn
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I have supplemental insurance to cover the other 20%. I had no choice or I would go into debt with all the medical treatments, doctor visits, and tests. I have Aetna Medicare. Besides paying for the insurance each month and co pays for doctor visits, I do not pay anything when I go to the hospital for the Remicade.
11-01-2009, 04:34 PM   #6
My Butt Hurts
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Hey BZ. I believe that there is a test that they can do whcih would tell you if you have formed antibodies to Remi or not.
This is just an estimate, but my Remi is about $4,000/treatment and it is every 8 weeks. My Humira was about $2,000 if I remember correctly, and that was every 2 weeks (that's for the one shot. You start with 4, then 2, then 1). That is all before insurance, so those #s might not even help you. I'm sure if you call whomever covers you, they would be able to tell you how much it wold be out of pocket before you decide. Also, Humira and Remicade have a co-pay assistance program I think. Do a search on here maybe. I think KatieSue has discussed it before.
Good luck. I hope you are able to work something out.
11-01-2009, 04:53 PM   #7
katiesue1506
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Yes, they both have copay assistance programs. The Remistart program "is a patient rebate program that can offer up to $400 per infusion rebate for eligible patients. Patients must be beginning or currently receiving treatment with REMICADE for an FDA-approved indication. Patients must have commercial insurance that covers medication costs for REMICADE, but have a medication co-payment greater than $100"

The Humira copay assistance card can make your Humira only $5 a month with a card that they send you. The card is good for a year and then you just have to reapply for the next year. Without the program my Humira is $50 a month after insurance.

I would say if you have the money, go for the Remicade antibodies blood test. I think it was $1400 and its only done through one company. Remicade tends to do the best job for longer periods of time.

I may sound dumb or ignorant, but I was wondering... if you are blind, would you be able to inject yourself with the Humira? Or do you have someone that can do it for you? Humira is a self-administered shot you give yourself usually every 2 weeks in the tops of the legs or the belly.

Welcome to the forum BTW, I'm from Indiana too. I'm currently seeking treatment at IU Med Center in downtown Indy because my GI gave up on me, so I know the whole "drive to town" thing... takes about 2 hours for me to get to my current GI's office and then I usually have to wait 2 hours to see him (ha!) and by the end of it I've wasted 6 hours. I hope you figure out which one you'd like to take!
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