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New Besremi pen: Anyone using it?
I watched a video demonstrating the Besremi pen. To switch from the syringe to the pen may require a new pre-authorization from your insurance. I am waiting for the approval so I can begin using it next week. The main advantage of the pen is a dial to select the exact dosage. You still have to connect the needle to the syringe. There are 4 new steps called Flow Check to make sure the fluid gets to the end of the pen. There is a button you push and hold instead of the plunger on the syringe. Instead of removing excess fluid before the injection, the excess fluid remains in the syringe and is disposed of. At the end of the video, there is a listing of adverse events. One I had not heard of was related to cardiovascular damage - damage to the heart or blood vessels. My doctor recently detected a heart murmur, which could be a sign of trouble or not.
I am getting an echocardiogram in November to try to determine the cause of the murmur.
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Has anyone started using this pen in the US? I'm wondering how the cost compares with the syringe? I would think the risks would be the same with both methods of using, no?
I am getting my first pens next week. The cash price of Besremi is around $18,000 per month, so I doubt changing to the pen would make much difference. I am on Medicare Advantage with a drug cap of $2100, so the first month of Besremi reaches the cap. I also take Skyrizi which uses a pen and is very similar. You keep it next to the skin and push a button. Then you count to 10 or so and remove it.
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2 ReactionsI get Besremi for the first time this upcoming Tuesday. I don't know which version it is. My cost is $2083 for 2 doses. It appears my insurance won't cover it at all. I'm looking for new insurance and a new primary care doctor for January. I was diagnosed with ET in February 2026, started Hydroxyurea in March, no side effects that I've noticed. But I do have a much lower level of energy that I had a year ago. My diagnosis has changed to myelofibrosis, 30% of my bone marrow has grade 2 fibrosis, 70% is grade 1. I've tried to search for what is normal amount of fibrosis for someone in their 70s, haven't found that yet. Fortunately, my spleen, liver, and kidneys are fine.
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1 ReactionI would recommend that anyone with an mpn consult with an mpn specialist if they don't have one, in addition to their hematologist. My hematologist wanted to keep me on hydroxyurea, but after consulting with my mpn specialist, I was able to get on Besremi. I have read that Jakafi/ruxalitinib is the primary treatment for myelofibrosis, but there are others.
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1 ReactionBlood Cancer United (formerly Leukemia and Lymphoma Society) has a service to help match patients with insurance plans and provide financial assistance.
https://bloodcancerunited.org/financial-assistance
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2 ReactionsI have Humana Medicare Part D for drug prescriptions and Besremi is covered in full once I hit the $2100 cap for Medicare. Not sure about the pen but they pay for syringes in full.
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1 ReactionInteresting. I have waited for months to get pens instead of syringes but after three times using syringe I am getting used to it. I didn’t realize pens had a lot of steps too! I thought it was more a point and shoot idea. Did you mean the pen has more tendency to cardiovascular events or just Besremi in general?
@eferret Thank you! That will be helpful in my search!
I think if you decided to use the pen, your doctor would have to prescribe it and your insurance company would have to approve it. In some ways I regret switching to the pen because with all of its extra steps, it is really not much of an upgrade from the syringe. With my Skyrizi pen I just take it out of the box, put it next to my stomach and push a button. However, I think the Besremi pen will eventually replace the syringe so the syringe will be discontinued.
As far as side effects are concerned, it is sometimes difficult to be absolutely certain that a side effect is caused by a particular drug. About 6 months after beginning to use Besremi, I started getting dry, flaky skin on my face and scalp. I went to see a dermatologist, and after about 6 months he diagnosed it as psoriasis, a chronic skin condition. He was reluctant to assign the cause to Besremi or anything else. He prescribed Skyrizi and the symptoms disappeared. If my test in November confirms I have a faulty heart valve, it could be caused by normal wear and tear on the body, by Besremi or something else. Before taking a new drug, I always go to drugs.com to learn as much as I can about side effects, patient reviews and drug interactions. These are things that doctors are not always aware of. My wife is taking Lisinopril for high blood pressure. Since she started taking it a couple of years ago, she has had a bad cough, especially in the evening. She recently told her doctor about it, and he is switching her to a different drug. He has had very few complaints from other patients about it. I looked up the reviews about the drug on drugs.com. Around 29% of the patient reviews mentioned a dry cough.
So the more we can discover on our own about the drugs we use, we are better off.
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1 Reaction@nancyra, I am currently comparing Part D plans in advance of Medicare open enrollment. Since my hematologist is suggesting that I switch to Besremi and Humana is one of the insurance options available to me, may I ask which plan you're on? Humana Basic Rx? Thanks! ~ Wendy