Insurance denial of Xeljanz

Insurance denial of Xeljanz

I've been on Enbrel for 2+ years and Humira prior to that. Enbrel worked fairly for the first year or so but I've been having a lot of joint damage in my fingers. Not much pain though. After my last Rheumatologist visit he has suggested trying Xeljanz and has submitted a prescription to my pharmacy (CVS Specialty Pharmacy). So far it has been rejected and they want me to first try Kevzara and Orencia. I haven't found anyone who has used Kevzara and it was only approved in 2017. I know… read more

A myRAteam Member said:

My dr was trying to get me on xeljanz Xr and it kept getting rejected he didn’t think they still used plain xeljanz 5 mg but once he tried plain Xeljanz it went right thru. It has worked really well for me. It’s really expensive though on my Medicare plan D it’s $200 a month. But without it quality of life would be horrible. It’s worth it to me

posted almost 2 years ago
A myRAteam Member said:

I was on oriencia for two years but going on Medicare switched to Xeljanz because I don’t wNt infusions or injections at doctors office
Medicare won’t let u inject at home
Pill form much better

posted over 1 year ago
A myRAteam Member said:

I tried a sample of Zeljantz and it worked well for me but my insurance denied it and recommended Humira. My doctor gave me a sample dose pack of Kevzara and my insurance approved it. I have been on Kevzara for over a year now and it works well for me along with the Methotrexate. In November I developed pneumonia and had to stop my rheumatoid meds. It triggered severe arthritis pain in my back and legs with numbness. Usually a Toradol injection would work, it didn't. I ended up having a bilateral epidural and that took close to six weeks to help, it normally helps in 2 weeks. I was on the surgery schedule to do an permanent nerve block but cancelled the day before my surgery which was 4 weeks after my epidural. I am so glad I gave myself more time. I can get out of bed without trying to figure out how to stand up straight and I haven't had any pain meds or muscle relaxer in more than two weeks. I am still working full time 12 hour shifts as a respiratory therapist too.
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posted 6 months ago
A myRAteam Member said:

Failed Zeljantz. Elevated BP, swollen ankles, fast heartbeat. All typical side effects. Luckily my RA had samples to try before going thru the insurance process. Have been orencia for 6 mos now and doing well.

posted 10 months ago
A myRAteam Member said:

I was given a months supply of Xeljanz and it worked well for me but my insurance did not approve it, they recommended Humira. My doctor gave me a sample of Kevzara and my insurance approved this medication but it is an injection. I have be on Kevzara for about six months and all of my labs are close to normal. It has been a year since I developed RA symptoms and I have minor aches and stiffness now. I didn't think the Kevzara was working well but my labs tell a different story. I am also on Methotrexate and Folic Acid. I have gone from being unable to open doors, unable take the gas cap off the truck, and having to wait for the grand kids to come home from school to get me out of my hospital scrubs, to being completely functional. I am tired a lot but I work 12 shifts fulltime, have other health issues and am 70 years old.

posted about 1 year ago
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