1. < Polymyalgia Rheumatica (PMR)

Newly diagnosed with PMR taking prednisone 15 mg. Working well. Dr wan

Posted by nanniepie @nanniepie, 6 days ago

Newly diagnosed with PMR on 15 prednisone doing well Dr wants to start IV infusion Actemra I’m scared. Any comments

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linda7 | @linda7 | 4 days ago
In reply to @sandmason "I thought Medicare would only cover Kevzara if it was given in a dr office or..." + (show)
@sandmason

I thought Medicare would only cover Kevzara if it was given in a dr office or infusion center. Moot point as it can cause colon rupture and diverticulitis disqualifies one. DV probably caused by 2 years of prednisone weakening colon tissues.

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The last time I checked Kevzara was not sold as an infusion but Actemra is. I was giving myself injections, which the drug company supplied, at home. Medicare has approved Kevzara for PMR so they should cover the only available form which is home injections. The insurance company for my drug plan told me to have my doctor contact them and apply for an exception which he is doing. If that fails I will go off Kevzara and see how I do on prednisone alone or possibly get on Actemra infusions since I do have some GCA symptoms, maybe a sub-clinical case. Cost estimate for the Kevzara is $63,000 for next year.

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daroberts73 | @daroberts73 | 4 days ago
In reply to @karo89135 "Hi daroberts73, I have additional insurance through United Airlines. It was covered once last year by..." + (show)
@karo89135

Hi daroberts73,

I have additional insurance through United Airlines. It was covered once last year by previous rheumatologist, then
NOT covered for
2025 but Actemra was substituted for 2025. No doctor can give a conclusive diagnosis for me so basically making decisions myself.

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Thank you all for the comments, my new doctor,as the old one has moved on
to a new place is going to change me to something else next week. I have
been really good on kevzara, but can't afford to empty my 401 k now! I hope
to live another 10 years

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1 reply
karo89135 | @karo89135 | 4 days ago
In reply to @daroberts73 "Thank you all for the comments, my new doctor,as the old one has moved on to..." + (show)
@daroberts73

Thank you all for the comments, my new doctor,as the old one has moved on
to a new place is going to change me to something else next week. I have
been really good on kevzara, but can't afford to empty my 401 k now! I hope
to live another 10 years

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Hah, I understand that. I saw what insurance paid. Wish I could send you mine since I'm very allergic to it. What a waste. Something did help the hand pain, either methotrexate or kevzara. First Actemra tomorrow but will have at doctor office. Goal is decrease prednisone 1mg per month and treat GCA.
Good luck to you!
Karo

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