Posts: 408
Threads: 9
Joined: Jan 2012
Gender: Female
Location: Danville, Kentucky
Treatment: Triamcinolone Acetonide Cream, Methotrexate
Dealing with a lot of pain and tenderness in my heels for many months now. along with other joint pain. Can't hardly walk most morning and nights. Also having trouble getting my Enbrel. Considering I been on it ten years it shouldn't be hard to get it filled. Getting the run around with the specialty pharmacy our insurance switch to this year. They should of kept it the same didn't have any trouble with the one I was using for 10 years. Hope I get it soon. My psoriasis is flaring. Went dermatologist last month and I can't get into rheumatologist till sometime in February. Just frustrated and tired of hurting so much.
Posts: 47,972
Threads: 357
Joined: Oct 2013
Gender: Male
Location: Norwich England
Psoriasis Score: 3
Treatment: Skilarence 5x120mg a day
(Sun-21-09-2014, 00:42 AM)KyPrincess Wrote: Dealing with a lot of pain and tenderness in my heels for many months now. along with other joint pain. Can't hardly walk most morning and nights. Also having trouble getting my Enbrel. Considering I been on it ten years it shouldn't be hard to get it filled. Getting the run around with the specialty pharmacy our insurance switch to this year. They should of kept it the same didn't have any trouble with the one I was using for 10 years. Hope I get it soon. My psoriasis is flaring. Went dermatologist last month and I can't get into rheumatologist till sometime in February. Just frustrated and tired of hurting so much.
Oh Sarah
I was assuming as we hadn't seen you you were clear, I'm sure you are putting pressure on the pharmacy for urgent action.
Isn't there someone you can appeal to for an emergency prescription?
Your system is so different to ours over here so I don't know what's possible....
But it's clear you aren't doing well, and when you know a fix of Enbrel will give you relief, and it's being withheld it's almost criminal
I hope you can get some pain relief soon and get the psoriasis back under control. I'm so sorry these companies treat human beings like this. They should suffer some of the pain
Jim
Posts: 1,624
Threads: 6
Joined: Dec 2012
Gender: Male
Location: Queensland
Treatment: Dimethyl fumarate
Yes, it is disgusting and you have my complete sympathy. Governments and insurance companies get away with this behaviour because of the small number afflicted. And from what I read people must endure second rate therapies and then be riddled with plaques and pain before they are begrudgingly offered effective therapies. Like Caroline and Jim I have had great results with DMF, and the fact that my drug cost is under $25 US annually leaves me utterly flummoxed as to why the regulatory authorities in conjunction with the medical specialists cannot organise timely and effective therapies.
Incompetent and uncaring tossers!
Cheers,
Bill
Posts: 71,229
Threads: 4,130
Joined: Aug 2011
Gender: Male
Location: France
Psoriasis Score: Zero
Psoriatic Arthritis Score: 1
PQOLS: 1
Treatment: Bimzelx / Coconut Oil
(Sun-21-09-2014, 00:42 AM)KyPrincess Wrote: Dealing with a lot of pain and tenderness in my heels for many months now. along with other joint pain. Can't hardly walk most morning and nights. Also having trouble getting my Enbrel. Considering I been on it ten years it shouldn't be hard to get it filled. Getting the run around with the specialty pharmacy our insurance switch to this year. They should of kept it the same didn't have any trouble with the one I was using for 10 years. Hope I get it soon. My psoriasis is flaring. Went dermatologist last month and I can't get into rheumatologist till sometime in February. Just frustrated and tired of hurting so much.
Hello Sarah, sorry to hear things are not good for you at the moment.
I'm like Jim, Sorry but I don't know enough about your health system over there to be able to offer any advice on what you should do next. It may be worth having a word with [user=528] as he knows his way around the USA health care, I'm not saying he has all the answers but he may have a few tips that could help.
Sarah I cant remember, do you have Psoriatic Arthritis? The reason I ask is it's sounding like it could be either the onset or a flar-up. Try keeping you feet elevated on something soft for a few days, it may help a little.
Here's a couple of threads that mention the Achille's tendon:
[thread=2130]
[thread=2039]
Shame you cant get a rheumatology appointment till February, maybe go back to your dermatologist and request they talk to them directly and see if you can be pushed forward as it's to difficult for you to do day to day things.
Sorry I couldn't be more help, but like others said. Were right behind you and don't hesitate to shout out.
Posts: 527
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Gender: Female
Location: On the fence
Psoriasis Score: 32
Treatment: Sandpaper
Thinking of you Sarah
Posts: 408
Threads: 9
Joined: Jan 2012
Gender: Female
Location: Danville, Kentucky
Treatment: Triamcinolone Acetonide Cream, Methotrexate
Thu-25-09-2014, 01:53 AM
(This post was last modified: Thu-25-09-2014, 02:08 AM by KyPrincess.)
Saturday I received a denial letter for Enbrel through the new pharmacy services prior authorization department that our insurance goes through. Saying that the practitioner or pharmacist has reviewed the information provided by my dermatologist. They denied it due to their prior authorization policy specific to my condition. That I did not fulfill step therapy. That I should only be on Enbrel after I try Humira and it failure to help...... I am so pissed. What gives them the right to say what treatment I should be doing. When they haven't seen me or my medical records from my dermatologist for the last 23 years to know what medicines I have been on. I have been on Enbrel for the last ten years. Just wondering if I have to go through all the treatment steps in the policy. That is just crazy. My dermatologist has now prescribe me Humira. So I am waiting to see if their prior authorization department will approve it. I don't know how long that would take.
Posts: 28,484
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Joined: Nov 2011
Gender: Female
Location: In between the tulips
Psoriasis Score: 3
Psoriatic Arthritis Score: 3
PQOLS: 4
Treatment: Got back to DMF slow release
Yes Sarah, those policies are dreadful.
They are prescribed by the insurance companies who don't have any knowledge about healing people, as that is of course the field of the doctors.
There is 'some' sense in it in trying to keep costs down, but it is always uniform, and the problem is, patients are not uniform, all of us are individuals. And as individuals we need an individual treatment.
We see the effects of the US approach also over here in Europe, certainly in the large hospitals where they stick to the procedures. But still we can influence things over here, we still have more power coming from the doctors that prescribe the medication.
Posts: 63
Threads: 5
Joined: Nov 2013
Gender: Female
Location: Scotland
Psoriasis Score: 32
Treatment: Epiderm, diprosalic, bentnovate, silkis, dermovate, diprobase, UVA
Hi Sarah,
Have you tried the insoles that are raised on one side? I have them from podiatrist, it doesn't cure the problem with the heels and feet but does make it a little easier.
Sandra
Posts: 47,972
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Joined: Oct 2013
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Location: Norwich England
Psoriasis Score: 3
Treatment: Skilarence 5x120mg a day
(Thu-25-09-2014, 01:53 AM)KyPrincess Wrote: Saturday I received a denial letter for Enbrel through the new pharmacy services prior authorization department that our insurance goes through. Saying that the practitioner or pharmacist has reviewed the information provided by my dermatologist. They denied it due to their prior authorization policy specific to my condition. That I did not fulfill step therapy. That I should only be on Enbrel after I try Humira and it failure to help...... I am so pissed. What gives them the right to say what treatment I should be doing. When they haven't seen me or my medical records from my dermatologist for the last 23 years to know what medicines I have been on. I have been on Enbrel for the last ten years. Just wondering if I have to go through all the treatment steps in the policy. That is just crazy. My dermatologist has now prescribe me Humira. So I am waiting to see if their prior authorization department will approve it. I don't know how long that would take.
Hi Sarah
What a bloody shame that they are asking you to go back to square one have you tried the route of asking Enbrel to fight your corner
have you contacted Enbrel on their website where they offer help and support for clients that are refused Fred pointed me at these sites regarding another members problems.... However it may be a route you have already investigated if not go to this post[post=166] at the bottom is a link to their website, and a button for help with finance. They may offer help with the difference in cost rather than lose a client
I would say it's worth a shot
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