Who is on Rinvoq for GCA vs Actemra?

@fore IV infusions are covered by your major medical insurance, Rinvoq is a pill and is covered by your drug plan, two very different insurance policies. Thus, the difference in coverage! It's not the drug it is the manner of delivery that is the distinguisher.

Actemra didn't work for me. I had a relapse of GCA. Switched to Rinvoq this March and was told I'd be on it for at least a year. I am now down to 7mg prednisone for GCA/PMR.

@emrose The cost of Rinvoq here is $9042.15 a month, for which I am covered.

@emrose

Wow ... I'm surprised that it costs that much. Health care costs are notoriously hard to pin down what the real costs are. I'm always surprised by how much is billed to insurance compared to the insurance approved amount and what the patient actually pays. The system for health care costs and insurance reimbursements in the USA isn't very transparent.

The following is what is on the internet for a 30 day supply of Rinvoq
Retail (No Insurance) $8,850 – $9,640
GoodRx / SingleCare $6,567 – $6,895
Commercial Insurance $0 – $60 (with Savings Card)
Medicaid $8.00 or less (state dependent)
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Medicare is another beast to figure out with Advantage Plans, Medicare Supplement Plans and Part D drug plans.

I think Rinvoq is FDA approved for GCA only and not yet for PMR. That doesn't mean doctors can't prescribe Rinvoq for PMR but insurance companies might have a reason for not covering Rinvoq if a patient only has PMR. It seems doctors have more choices if patients have both PMR and GCtA . Otherwise doctors can just say "presumptive GCA" if they aren't sure and want to try Rinvoq for their PMR patients.

I'm doing monthly Actemra infusions and it isn't FDA approved for PMR. I have never been diagnosed with GCA . Actemra is only FDA approved for GCA and I'm diagnosed with PMR only. My doctor needed to get authorization to prescribe Actemra to me. Actemra was authorized with the stipulation that I'm treated with GCA protocols "as if I had GCA."

More and more ... I think PMR and GCA are being treated as if they are the same because of how the conditions are "associated." The research being done seems to apply to both PMR and GCA.

I believe you are correct with Rinvoq only approved for GCA. I’m on it. It is insanely expensive. Medicare and my supplemental cover most of it. It’s billed at $6,300 USD. I like it because it’s a once a day pill. Down to 4 mg prednisone now.

I was diagnosed with PMR almost a year ago. Have been on prednisone (adjusted dosages) at times w/methatrexate. I really would like to get off steroids because of the weight gain/hair loss/insomnia. Would like to try Rinzoq but have had blood clots in my leg so not sure if I should?

@dadcue
my copay for Rinvoq is $85 - I am on a State Employee Health Plan for Retired Teachers. Cost is around 8600.00
Stating to taper from 40 Mg. of Prednisone since my GCA diagnosis. Looking forward to the conitnued taper - I want off the Prednisone. I was down to 7mg a day of Prednisone prior to my GCA episode!
We are all on this journey !

@maryjo3296
I was on Rinvoq for 2 months while I had blood clots in my legs. But I was also on Eliquis. Was switched to Actemra infusion. I have GCA.