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Rheum wants Kevzara but Methotrexate much cheaper, work as well?
Appreciate any input. I'm newly diagnosed 7/31/26. Started at 15mg, had to go to 20mg, then to 25mg for 2 weeks to get all pain and symptoms under control. Saw my Rheumatologist today, 1st follow-up. I tapered to 22.5mg 7 days ago. She's concerned re flares for me because I had to step up twice just to get under control initially. She wants me to start Kevzara to help me taper over time, hopefully without flares. The Kevzara & Methotrexate both require prior authorization to even get covered by my insurance. Kevzara shows 4,000.00+ price without insurance, while Methotrexate shows 200.00+without insurance. It's a no brainer for me as I've had way too much health expenses already this year. Anyone have experience they can relate about Kevzara, any side effects, or Methotrexate and any side effects? Or any other drug that can help bridge the Prednisone tapers? I appreciate any help at all. Thank you all.
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Some people tolerate methotrexate well, and some have a lot of side effects. My brother-in-law has been taking it for 14 years to treat PMR, and he hasn't had any problems with it.
I've been taking Actemra for more than 2 years. Actemra and Kevzara both block IL-6. I haven't had any side effects from the Actemra, other than some minor fatigue following the first few injections. I have a Medicare Advantage plan that pays for the Actemra with prior authorization. There is a limit this year of $2100 out of pocket to cover all medications. I think in January that will go up to $2200. If you are already taking some other expensive drugs, the Kevzara wouldn't add a lot to your expenses.
Also, depending on your income and insurance policy, there are copay assistance programs for people that take Kevzara and Actemra. Their manufacturers both have programs, and there are also other programs. Anyone who is interested can find more information online.
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4 ReactionsI have been on Kevzara a year now. Started out injecting every two weeks. About 9 months later switched to every month because my inflammation markers were normal. It has been a game changer for me and now I am slowly weaning off Kevzara. I am on Medicate Advantage so out of pocket is $2.100 a year but Kevzara has a few programs. Hope that helps.
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5 Reactions@laurelfagan ditto, Kevzara game changer
Medicare and United Healthcare…..$2100 out of pocket. Kevzara has some financial help on its website. No side effects…..except an occasional low WBC. Then we cutback the injections to every 3 weeks.
Note: I have no other health issue, 80yo female , hopefully winding down…..
🤞maybe off Kevzara by end of year.
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5 Reactions@jeff97 Thank you so much for all this info. I really appreciate it. I don't take any other expensive drugs, so I'll look at what my total drug max for year is. Really can't afford such high costs per year due to my husband's and my ages but probably make too much to qualify for help, but I'll check that as well for Kevzara and Actemra. This PMR support group is so helpful. I've learned so much from each post. Thank you again and Blessings on your journey.
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2 Reactions@laurelfagan
It does help, a lot. Thank you so much for all this information. It gives me ideas as well as hope for a future (hopefully) without Prednisone and (hopefully) without PMR, but I'll take it one day at a time. Blessings.
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2 Reactions@tweetypie13
Thank you so much for your response and information. Everything helps.
I hope you're able to get off the Kevzara by end of year, and be PMR free. Blessings.
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5 Reactions@tweetypie13 I was just going to ask you how you were. 2027.
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2 ReactionsGetting insurance to approve coverage and getting the medicine from manufacturers is indeed a problem. Seems these people want doctors to try other medicines. My experience anyway.
With Kevzara, the cost was covered after my annual deductible for that tier of drug.
Check with your doctors office on the cost.
I was on Kevzara but after the second and third had welts at injection site so my Rheumatologist took me off. I do believe it was helping and noticed a difference right away. I have not been on Methotrexate- from word of mouth and reading it seems to have more risks to it.
Right now I have been on another injection every two weeks but now when I reordered was told it wasn’t available.
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3 Reactions@abd
Thank you very much for this information. My Rheumatologist said that Kevzara could leave a "mark" or something, so thanks. Is the name of the most current medication you were told isn't available "Acetemra"? Is it the specialty pharmacy saying it isn't available? My Rheumatologist said you get Kevzara from a "specialty pharmacy" or something. It seems like it can be a problem, especially if you've been taking a "biologic" type drug that can be so helpful and then suddenly can't get it. I'm sorry this has happened to you. It's hard enough having PMR and taking Prednisone, trying to taper without horrible flares, and then having RX issues on top isn't our idea of fun!! Thanks again for your help. I hope you can get the most recent one ASAP. Blessings.
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2 Reactions@stonewheel all good, doing everything I did before, not necessarily as proficient or talented. My support group was and is large. Still,have my specialist trainer (20+ yrs and counting). Hoping blood work in 2 weeks 🤞, if so will stay at 3 week Kevzara intervals til January, hoping end date.
Thx asking.
Hope all good in your world.
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3 Reactions