1. < Polymyalgia Rheumatica (PMR)

Kevzara and Prednisone Tapering before and during Kevzara

Posted by mikeydee @mikeydee, Jul 3, 2023

I recently stated with Kevzara and I am interested in those who are currently on prednisone and Kevzara.
I would like to know...
1. What was your starting dosage of prednisone and how long have your been taking prednisone?
2. What was your daily dose of prednisone before Kevzara?
3. What was your prednisone tapering schedule before starting Kevzara?
4. What was your lowest dosage of prednisone before Kevzara and did you have difficulty dropping below that dose?
5. What is your tapering schedule now that you are on Kevzara?
6. How successful has this schedule been so far and have you had any flare ups?
7. What is your target date for stopping prednisone?
8. What changes have you noticed in your health, aches and energy level since starting Kevzara?
Please feel free to add any more information that might be helpful to those contemplating starting Kevzara or those currently on Kevzara
Thanks
Mike

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linda7 | @linda7 | Feb 11 10:42am

I have taken prednisone and methotrexate for 2.5 years and my disease appears to be chronic. My rheumatologist has mentioned Kevzara as an option and I am tired of the side effects of my present drugs. I am on Medicare A, B and D ( Aetna Silverscript for the D). I went on Medicare.gov and entered Kevzara as a medication that I take. Their calculation recommended staying on Silverscript and the monthly cost for Kevzara would be $280. Has anyone found a way to reduce this cost? The drug company offers co-pay assistance but I am not sure if people on straight Medicare and part D are eligible. Kevzara is not available as an infusion which would have better coverage.

REPLY
1 reply
wilmingtonemperor | @wilmingtonemperor | Feb 11 11:12am
In reply to @froehlich22 "I have been on Kevzara since Oct. 2023. I have tapered very slowly as I have..." + (show)
@froehlich22

I have been on Kevzara since Oct. 2023. I have tapered very slowly as I have relapsed before. When I started Kevzara, I was on Prednisone 10mg and Methotrexate 17.5 mg. I am currently down to 3 mg of Prednisone and 7.5mg of Metho. The Kevzara has really made a difference but now I’m challenged with the price of it. I have Kevzara co-pay card and Optum RX insurance, but in December they charged me personally almost $1600 for the 2 doses. I am going round and round with both companies. I may not be able to take it anymore do to the cost. What a bummer. Just when you start feeling good again:-(. Has anyone else had trouble with the co-pay card or any advice? Thank you.

Jump to this post

Hi again, I am retired military and so I have Medicare and Tricare for Life. The copay for 4 doses (2 months) just went to $76 from $68. I am very fortunate in that regard. I think the manufacture Sanofi/Regeneron has a program to help with the copay. Could I suggest contacting them?
Best,John

REPLY
wilmingtonemperor | @wilmingtonemperor | Feb 12 8:31am
In reply to @dadcue "All biologics are expensive and the cost of Kevzara is no different. There is a loophole..." + (show)
@dadcue

All biologics are expensive and the cost of Kevzara is no different.

There is a loophole for biologics given by infusion for people on Medicare. As long as the biologic is FDA approved for the condition being treated, Medicare will pay 80% of the cost to do an infusion. A good Medicare supplement will pay the remaining 20%.

"Injectable and infused drugs: Medicare covers most injectable and infused drugs when a licensed medical provider gives them, because these types of drugs aren't usually self-administered."

https://www.medicare.gov/coverage/prescription-drugs-outpatient

An injectable biologic usually isn't covered because it isn't "medically necessary" for a licensed medical provider to administer them. However, an infusion needs a nurse or someone who is qualified to start an IV and give the medication.

Unfortunately, I don't think Kevzara is available by infusion. For people with GCA however, Actemra can be given by infusion.

Jump to this post

Darcie, it is just wrong that because Kevzara is self administered as opposed to an infusion that D England and others are being held up by these 3d party plan managers. I would think that not having a provider administer a drug and not have to pay for an office visit would be a no brainer for the insurance companies.

REPLY
2 replies
wilmingtonemperor | @wilmingtonemperor | Feb 12 8:32am
In reply to @wilmingtonemperor "Darcie, it is just wrong that because Kevzara is self administered as opposed to an infusion..." + (show)
@wilmingtonemperor

Darcie, it is just wrong that because Kevzara is self administered as opposed to an infusion that D England and others are being held up by these 3d party plan managers. I would think that not having a provider administer a drug and not have to pay for an office visit would be a no brainer for the insurance companies.

Jump to this post

I meant Dad Cue. Hate autocorrect

REPLY
harelover | @harelover | Feb 12 8:47am
In reply to @froehlich22 "I have been on Kevzara since Oct. 2023. I have tapered very slowly as I have..." + (show)
@froehlich22

I have been on Kevzara since Oct. 2023. I have tapered very slowly as I have relapsed before. When I started Kevzara, I was on Prednisone 10mg and Methotrexate 17.5 mg. I am currently down to 3 mg of Prednisone and 7.5mg of Metho. The Kevzara has really made a difference but now I’m challenged with the price of it. I have Kevzara co-pay card and Optum RX insurance, but in December they charged me personally almost $1600 for the 2 doses. I am going round and round with both companies. I may not be able to take it anymore do to the cost. What a bummer. Just when you start feeling good again:-(. Has anyone else had trouble with the co-pay card or any advice? Thank you.

Jump to this post

I am about to start Kevzara but would not have been able to since the cost to me would have been close to $2k every 28 days. I applied for patient assistance through the drug company and will be receiving the med at no cost to me. I am on Medicare and a good supplemental plan but the coverage was not good enough to pay for all of it. The process is fairly simple and it’s done through their website. I hope this helps you and that you are able to stay with the treatment especially since it seems to be working for you.

REPLY
2 replies
DadCue | @dadcue | Feb 12 10:59am
In reply to @wilmingtonemperor "Darcie, it is just wrong that because Kevzara is self administered as opposed to an infusion..." + (show)
@wilmingtonemperor

Darcie, it is just wrong that because Kevzara is self administered as opposed to an infusion that D England and others are being held up by these 3d party plan managers. I would think that not having a provider administer a drug and not have to pay for an office visit would be a no brainer for the insurance companies.

Jump to this post

Nobody asked me when they crafted Medicare rules. I agree with you that it makes no sense.

The VA could have denied my rheumatologist’s request for Actemra since I wasn’t diagnosed with GCA. Actemra isn’t FDA approved for PMR.

The VA doesn’t have to abide by Medicare rules thankfully.

You can call me Mike if you wish.

REPLY
froehlich22 | @froehlich22 | Feb 12 6:38pm

I am not on Medicare. I have BCBS with Optum RX for my prescriptions. Kevzara is running about 4000 a month. My insurance covers about 2400/month with Kevzara covering about 1600/mo.
Just ridiculous that the Pharma can charge that much for a FDA approved drug. It is a 1cc injection every 2 weeks.

REPLY
froehlich22 | @froehlich22 | Feb 12 6:42pm
In reply to @harelover "I am about to start Kevzara but would not have been able to since the cost..." + (show)
@harelover

I am about to start Kevzara but would not have been able to since the cost to me would have been close to $2k every 28 days. I applied for patient assistance through the drug company and will be receiving the med at no cost to me. I am on Medicare and a good supplemental plan but the coverage was not good enough to pay for all of it. The process is fairly simple and it’s done through their website. I hope this helps you and that you are able to stay with the treatment especially since it seems to be working for you.

Jump to this post

Just be careful-I assume you have the copay card? They pd for mine Oct, Nov, Jan but not December. I owe my pharmacy $1600. I am working with both but may I suggest to you that you call Kevzara monthly to check on your status so you don’t end up with a large bill like I have for reasons unknown. They are working on it.

REPLY
1 reply
froehlich22 | @froehlich22 | Feb 12 6:44pm
In reply to @linda7 "I have taken prednisone and methotrexate for 2.5 years and my disease appears to be chronic...." + (show)
@linda7

I have taken prednisone and methotrexate for 2.5 years and my disease appears to be chronic. My rheumatologist has mentioned Kevzara as an option and I am tired of the side effects of my present drugs. I am on Medicare A, B and D ( Aetna Silverscript for the D). I went on Medicare.gov and entered Kevzara as a medication that I take. Their calculation recommended staying on Silverscript and the monthly cost for Kevzara would be $280. Has anyone found a way to reduce this cost? The drug company offers co-pay assistance but I am not sure if people on straight Medicare and part D are eligible. Kevzara is not available as an infusion which would have better coverage.

Jump to this post

They should. Check their website.

REPLY
harelover | @harelover | Feb 13 5:46am
In reply to @froehlich22 "Just be careful-I assume you have the copay card? They pd for mine Oct, Nov, Jan..." + (show)
@froehlich22

Just be careful-I assume you have the copay card? They pd for mine Oct, Nov, Jan but not December. I owe my pharmacy $1600. I am working with both but may I suggest to you that you call Kevzara monthly to check on your status so you don’t end up with a large bill like I have for reasons unknown. They are working on it.

Jump to this post

I do not have a co-pay card since I do not get it through my pharmacy. I have been approved for the drug through KevzaraConnect. They ship the medication to me every month. I will have to be re-approved again at the end of 2024. I pray I won’t need to take this drug beyond that. I haven’t even started this medication so I don’t even know if it will work for me.

REPLY
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