@kathren I have several comments and questions about your post.

I'm surprised that your rheumatologist said Actemra infusions are more consistent than biweekly injections. I take weekly injections. I would think weekly injections are at least as consistent as monthly infusions, if not more so. I'm surprised he didn't mention the option of weekly injections to you. I would think the out of pocket for you would be the same for weekly or biweekly injections, since both would exceed your maximum for the year.

I'm glad to hear you're feeling so good at 60 mg prednisone. I have GCA and PMR, and I had very bad insomnia for the 12 weeks I was above 40 mg of prednisone. I felt like a zombie during the day from not sleeping.

As far as I know, the other drugs for GCA are still very expensive. The only ones I know of are Rinvoq and Tyenne, which is a biosimilar drug to Actemra. Rinvoq is a pill, but it has a lot of potential side effects, and is more expensive than Actemra. Tyenne is cheaper than Actemra, but I think it would still exceed your maximum out of pocket.

I have been taking Actemra for a year, and I expect to keep taking it for at least a couple more years. There is some risk of relapse even when you're taking Actemra, and the risk does go up once you stop taking it. But I am really enjoying the way I feel now that I'm almost finished with prednisone (1 mg per day). I'm feeling much better than I have in several years.