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Questions about Crohn's Disease

Digestive Health | Last Active: Jun 6, 2023 | Replies (7)

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@jejonesdds1

Thanks so much for the response. Much appreciated!! Yes, I do indeed plan on getting a second opinion. The provider who called me about the MRI results is actually a P.A., but he told me the actual MD is onboard with his analysis. I don't want to start this kind of treatment with just a P.A.'s recommendation. He never mentioned prednisone at all, but maybe the fact that I have pre-diabetes may have been a factor in that.

My biggest concern is the Remicade or Humira. Is one more effective than the other? The infusion thing sounds like a hassle, but I could live with Humira injections every 2 weeks I think. The other thing is cost for these drugs...I know they are very expensive. The P.A. seemed to be pushing the Remicade (the office he works out of does have an infusion clinic attached, so he may be biased towards Remicade?). He told me that Medicare would probably cover most of the Remicade infusions through either Part A or Part B. Humira would be covered under the Part B drug coverage, but depending on my particular coverage there could be a significant copay. Also there are the published possible side effects from those two drugs that are kinda scary. Do you or anyone else have any insight into the side effects?

Again, thanks for the reply.

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Replies to "Thanks so much for the response. Much appreciated!! Yes, I do indeed plan on getting a..."

Remicade is one of the biologics with the longest/best track record for Crohns, so it seems to be often the first recommended ... that said, as you have seemed to uncover on your own, there is a lot of money involved which opens the door for conflicts of interest.

I do not know how paying for these drugs works if you are on various forms of government insurance. Be sure to research the manufacturer's copay assist plans, although maybe these specifically exclude Medicare if I recall.

As far as side-effects go, with prednisone you are pretty much guaranteed to get negative side-effects (but that drug may be off the table for you anyways, I would do more investigation into this because pred can be very helpful despite its negativity) vs with biologics there is a laundry list of things that happened to people while on the drug that the FDA seems obligated to include to cover their butts. Again, I am sorry to say but you may have a serious of "lesser of two evils" decisions coming up, nature of the game.