Cosentyx - Week 1....and beyond....

[mataribot]

Hi All!!   Been on Cosentyx since July 2015.   I am almost cleared up except for patch on my lower left leg which is starting to clear but very stubborn.   I still have a couple of spots on my forehead area which pop up and some behind my ears.   My inverse spot comes and goes.  Still have some side effects for about 1 to 5 days after my 2 injections....go to the bathroom more....headache, nausea.   Still on the ZERO co pay plan.  They said after January 1st they don't know what will happen.   My insurance will be with the same company but my coverage will NOT be as good as it is now.  Cosentyx is about 4,500 a month if you have to pay for it yourself.  Who can afford that!!  I am hopeful the zero co pay plan will still exist on January 1, 2016.  If I get BOOTED off of this drug I will be very upset.  I am hopeful they offer financial assistance or something so I can continue it.  My insurance has a prescription plan  but but now I will be responsible for probably about $3,000 a month instead of possibly $45 like it would be right now.   No one can shed any light on the matter.  I have called the people at Novartis as well as my insurance company.  They said it's a wait and see thing!   How convenient for them.....

I have that silly bathroom problem as well - makes me go diarrhea for about a week.

[Kat]

Hi All!!   Been on Cosentyx since July 2015.   I am almost cleared up except for patch on my lower left leg which is starting to clear but very stubborn.   I still have a couple of spots on my forehead area which pop up and some behind my ears.   My inverse spot comes and goes.  Still have some side effects for about 1 to 5 days after my 2 injections....go to the bathroom more....headache, nausea.   Still on the ZERO co pay plan.  They said after January 1st they don't know what will happen.   My insurance will be with the same company but my coverage will NOT be as good as it is now.  Cosentyx is about 4,500 a month if you have to pay for it yourself.  Who can afford that!!  I am hopeful the zero co pay plan will still exist on January 1, 2016.  If I get BOOTED off of this drug I will be very upset.  I am hopeful they offer financial assistance or something so I can continue it.  My insurance has a prescription plan  but but now I will be responsible for probably about $3,000 a month instead of possibly $45 like it would be right now.   No one can shed any light on the matter.  I have called the people at Novartis as well as my insurance company.  They said it's a wait and see thing!   How convenient for them.....

Isn't the US insurance system great? Yes that was sarcasm!

Insurance is big business and if you follow the news there have been some problems with companies losing money on Obamacare. United Healthcare is even talking about leaving the healthcare marketplace due to their losses. We are also noticing some changes in our insurance for next year, higher costs and deductibles. It seems to me that the Affordable Care Act (Obamacare) has only made things worse overall. Don't get me wrong, there should be healthcare available to all (and they should have looked at the existing system of Medicaid and have our already taxed dollars go towards insuring people as opposed to a Marketplace that insurance companies are going to have to increase rates to cover those that can't pay) Sorry, I'm getting a bit off topic here with my personal opinion.

There are prescription plans that you can add yourself (on top of your current insurance) but I've always been a bit leery of trying them. I'm constantly getting mail for them and even noticed at my last doc appointment that there was information on a few of them in his office. To me it's always looked like just someone else jumping on the insurance band wagon and wanting money to offer probably little in return, but I have heard some people say they are worth it so if all else fails, perhaps give that a look.

Have you already enrolled in your insurance for next year? You should be able to call them and see if they will continue your coverage on Cosentyx. At least then you will have a bit of a heads up on what will happen after the first of the year.

The ONLY advantage I think the US system has is the ability to choose your doctors and easily switch to another if not happy. I do like having that control. Sadly, that's about the only good thing I can think of anymore, as it costs dearly to have that choice. My primary doctor is even opting out of all insurance plans starting next year but that's a whole different subject.

[Caroline]

Insurance certainly is big business. I am totally with you on that. But Pharma is even much bigger, they earn weird amounts of money, still pretending to be poor. If medication was not so expensive, insurance could easily pay for it.

[angel-1963]

Yes, my insurance company was contacted already. I will have the same insurance company but they said they cannot tell me anything until after January 1st. Makes no sense to me at all. I called my Cosentyx rep. She has no clue if I will qualify any more for zero co pay program. It's like once you are on the medication they are done speaking with you anymore. I am going to be very very upset if I am pulled off of this medication in January and Cosentyx won't help me. You would think they have a financial program or some sort of help instead of letting you be yanked off the medication. It's like they dangle candy in front of you, you take it, it helps, and then poof it can be yanked away from you in an instant. I will keep you posted.

[Fred]

It's like they dangle candy in front of you, you take it, it helps, and then poof it can be yanked away from you in an instant.  

I would also question on what it could be doing to peoples health.

I'm not saying it's wrong to stop a treatment after a short term, but they don't seem to be taking the psychological effect in to account. Let's say you are 80% covered in psoriasis and your quality of life is very low, then you are given a treatment that gets you down to only 10% covered and improves your self esteem. Imagine the effect that can have on some people when suddenly the treatment that is working is taken away from you.

I know first hand on how well the bio treatments can work, but I also know how bad it can be when you have to stop one.

Sorry I better shut up, but to finish I will use one of your American sayings ............................... "Your system Sucks!"

[Caroline]

It's like they dangle candy in front of you, you take it, it helps, and then poof it can be yanked away from you in an instant.  

I would also question on what it could be doing to peoples health.

I'm not saying it's wrong to stop a treatment after a short term, but they don't seem to be taking the psychological effect in to account. Let's say you are 80% covered in psoriasis and your quality of life is very low, then you are given a treatment that gets you down to only 10% covered and improves your self esteem. Imagine the effect that can have on some people when suddenly the treatment that is working is taken away from you.

I know first hand on how well the bio treatments can work, but I also know how bad it can be when you have to stop one.

Sorry I better shut up, but to finish I will use one of your American sayings ............................... "Your system Sucks!"  

I think you would indeed be extremely upset. And to my idea you would have a reason to be upset. This could look like a form of blackmail. But let's wait. They must have some thoughts, but will not tell you, just like politicians.

[jiml]

It's like they dangle candy in front of you, you take it, it helps, and then poof it can be yanked away from you in an instant.  

I would also question on what it could be doing to peoples health.

I'm not saying it's wrong to stop a treatment after a short term, but they don't seem to be taking the psychological effect in to account. Let's say you are 80% covered in psoriasis and your quality of life is very low, then you are given a treatment that gets you down to only 10% covered and improves your self esteem. Imagine the effect that can have on some people when suddenly the treatment that is working is taken away from you.

I know first hand on how well the bio treatments can work, but I also know how bad it can be when you have to stop one.

Sorry I better shut up, but to finish I will use one of your American sayings ............................... "Your system Sucks!"  

I think you would indeed be extremely upset. And to my idea you would have a reason to be upset. This could look like a form of blackmail. But let's wait. They must have some thoughts, but will not tell you, just like politicians.

Is it a kind of brinkmanship the manufacturers play, to try to get the maximum price from the insurers. And they won't reveal their hand until the due date, and you sit there not knowing which way the game will pan out .... It's a nasty practice and something should be done to ensure that you get the treatment that works for you. There should not be fear that it will be taken away or substituted for something inferior

[jmysray]

Can you tell me if this is covered by most insurance.  Is it ok for me to ask if this is expensive,new to the board so if that is not a proper question my apologies in advance.

[Fred]

Can you tell me if this is covered by most insurance.  Is it ok for me to ask if this is expensive,new to the board so if that is not a proper question my apologies in advance.

Yes it's ok for you to ask. We are fully independent from any sponsors, advertising, or donations so we can give our own opinions without pharma companies breathing down our backs.

I'm not sure of the cost of Cosentyx but I do know it is being sold at around the same price of Stelara in the UK and France which is around €14,000 per year. I don't know the cost in the USA and you do have different systems in place for co payments. It could be worth starting a new thread and asking in Prescribed Treatments For Psoriasis as it may get you more answers.

[Bill]

Gosh. Me being such a big DMF fan and all, like Jim, Caroline, Bassman et al, I wonder why the biologics dont get used for a couple of months to do the heavy clearing, then try a switch to DMF for maintenance? This may be possible as some of the biologics seem to modify the disease at a fundamental level. If it were just keeping my skin clear I could do this with DMF at a cost of 13 cents a week. Health insurance companies are incredibly inefficient.

Cheers,

Bill