5400. Per month, ins. Has agreed to pay some on a monthly basis down to 2100. Per month.

I don't have that problem with Actemra infusions. Medicare pays for biologic infusions because they aren't considered to be "outpatient" medications. It is a shame that Medicare will pay for infusions and not injections just because injections are self administered.

Actemra has been around a relatively long time to treat RA and other things. If your doctor can do some"creative documentation" maybe he can sneak Actemra in for you. Saying something like "presumptive GCA" might work but the ethics of doing that is questionable. Actemra is FDA approved for GCA.

My rheumatologist had to get a waiver to get Actemra approved for me because I was only diagnosed with PMR. I didn't need a Medicare waiver but the waiver request was reviewed by a panel of doctors. A review board looked at my medical history and came back with an approval. The recommendation by the review board was that I should be treated "as if" I had GCA even though my rheumatologist didn't claim that I actually had GCA. My rheumatologist only claimed Actemra "should work" for PMR since the research done for GCA is fairly convincing.

After Actemra was approved, it wouldn't ever be unapproved as long as Actemra was working. I laughed, because I wouldn't want to take Actemra if it wasn't working well or had side effects. It isn't like Prednisone in the sense that it can't be stopped abruptly if necessary.

Kevzara is still patented so there won't be any generics anytime soon. Maybe the maker of Kevzara will come up with a formulation that can be infused but don't count on it. Actemra is no longer patented so there are already generics that are available.