1. < Polymyalgia Rheumatica (PMR)
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Kevzara insurance denial options

Posted by caroljeand @caroljeand, Feb 4 4:21pm

I have been on Kevzara for three months and have been receiving repeated denials for approval for 2026. Any suggestions from anyone who has experienced the same? What treatment is an effective substitute for kevzara? I will be taped off prednisone by February 20, hopefully.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

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marci516 | @marci516 | Feb 8 2:39pm

So good to hear! Very happy for you.

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kare1 | @kare1 | Feb 8 4:54pm
In reply to @jabrown0407 "@kare1 You know your doctor - so here are some thoughts. If you send messages via..." + (show)
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@kare1 You know your doctor - so here are some thoughts. If you send messages via portals like Epic's MyChart you could send a msg to your doctor saying you will go up to 4mg prednisone for now and are interested in their thoughts of considering you a candidate for a biologic.
Please do your online research before your appointment on the biologics so you know what you are suggesting. Keep an open mind when discussing it with your doctor.
There are definitely additional risks and you need to go into it with your eyes open so there are no surprises when a side effect hits.
You can have infusions at an infusion center or you can give yourself injections at home. There are pluses and minuses to each approach and that is something you also need to understand so you can discuss it with your doctor when the time comes.
Biologics are an entirely different class of medications, they can save lives and improve quality of life. Like everything else in the medical world the risk/benefit analysis needs to be understood to make an appropriate decision for you.

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@jabrown0407
Extremely good advice!! Thank you!!

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Mike | @dadcue | Feb 9 5:48am
In reply to @jabrown0407 "@kare1 You know your doctor - so here are some thoughts. If you send messages via..." + (show)
Profile picture for jabrown0407 @jabrown0407

@kare1 You know your doctor - so here are some thoughts. If you send messages via portals like Epic's MyChart you could send a msg to your doctor saying you will go up to 4mg prednisone for now and are interested in their thoughts of considering you a candidate for a biologic.
Please do your online research before your appointment on the biologics so you know what you are suggesting. Keep an open mind when discussing it with your doctor.
There are definitely additional risks and you need to go into it with your eyes open so there are no surprises when a side effect hits.
You can have infusions at an infusion center or you can give yourself injections at home. There are pluses and minuses to each approach and that is something you also need to understand so you can discuss it with your doctor when the time comes.
Biologics are an entirely different class of medications, they can save lives and improve quality of life. Like everything else in the medical world the risk/benefit analysis needs to be understood to make an appropriate decision for you.

Jump to this post

@jabrown0407

It sounds like you have a good grasp on how our medical system works which is part of the battle. The other part is about the realities of modern medicine ... nothing comes with any guarantee that it works perfectly for everyone. The rest is an economic question about costs and if it is worth it or not.

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