@lisanoelg1 For what it's worth - Rinvoq is supposed to be an excellent DMARD as well. I've been on both (it's just unfortunate I developed a DVT within a week of starting Rinvoq - but it's also close to the time I'd had Covid, so it was difficult to tell which was the cause, but because of the timing, I was advised to discontinue to the Rinvoq). Either way, hope she gets what she needs with less hassle. Or . . . just a thought, does she have the option to change her insurance? They're all painful to deal with, but maybe the pharmacist can point her to one that is better to deal with when it comes to getting drugs approved.