I know what you mean, you have to demonstrate that you are 'failing to progress' on the cheap and nasty drug before you get access to the expensive (almost as nasty) more effective drug. Its just wrong on many levels. As for getting access to Actemra, it seems so far off at the moment that im just taking one day at a time, trying not to let this disease drag me into a deep dark hole...i wake up and start asking myself "what can i be thankful for..i can still cook occasionally, i can still do a bit of craft with the grandkids, i can manage a bit of light cleaning with lots of rest breaks" not totally useless yet !!!!