How does Humira insurance cost affect patients. What are the potential savings options for Humira. How can patients navigate the complexities of Humira insurance coverage. What are the important safety considerations for Humira users. How does Humira impact various health conditions.

Navigating Humira Insurance Costs: What Patients Need to Know

Humira (adalimumab) is a widely prescribed medication for various autoimmune conditions. However, its cost can be a significant concern for many patients. Understanding the intricacies of Humira insurance coverage is crucial for those seeking to manage their treatment expenses effectively.

Insurance coverage for Humira varies depending on the provider and specific plan. Typically, patients may be responsible for copayments, coinsurance, or deductibles. The out-of-pocket costs can range from a few dollars to several hundred dollars per dose, depending on individual insurance plans.

Factors Affecting Humira Insurance Costs

• Type of insurance plan (HMO, PPO, etc.)
• Formulary tier placement of Humira
• Deductible and out-of-pocket maximum
• Prior authorization requirements
• Step therapy protocols

Does insurance typically cover Humira? Most insurance plans do cover Humira, but the extent of coverage can vary. Some plans may require patients to try less expensive alternatives before approving Humira, a process known as step therapy.

HUMIRA Complete: A Comprehensive Savings Program

HUMIRA Complete is a program designed to help patients navigate the financial aspects of their treatment. This initiative offers various resources and support to make Humira more accessible and affordable.

Key Features of HUMIRA Complete

1. Savings card for eligible patients
2. Insurance support and benefits verification
3. Nurse ambassador program
4. Injection training and resources
5. Ongoing support throughout treatment

How can patients access HUMIRA Complete? Patients can enroll in the program through their healthcare provider or by visiting the official HUMIRA website. The program assesses individual eligibility and provides personalized support based on each patient’s needs.

Maximizing Savings: Strategies for Reducing Humira Costs

While Humira can be expensive, there are several strategies patients can employ to reduce their out-of-pocket expenses. These approaches can help make the medication more affordable and accessible.

Effective Cost-Saving Methods

• Utilizing manufacturer copay assistance programs
• Exploring patient assistance programs for uninsured or underinsured individuals
• Investigating nonprofit organization grants
• Discussing lower-cost alternatives with healthcare providers
• Considering biosimilar options when available

Are there income restrictions for Humira savings programs? Some assistance programs do have income restrictions, while others are available regardless of income. It’s essential to review the eligibility criteria for each program carefully.

Critical Safety Information: What Humira Users Should Know

While Humira can be highly effective for many patients, it’s crucial to understand the potential risks and safety considerations associated with its use. The medication carries important safety information that all users should be aware of.

Key Safety Considerations

• Increased risk of serious infections
• Potential for certain types of cancer
• Risk of hepatitis B reactivation
• Possible neurological effects
• Allergic reactions and injection site reactions

Can patients start Humira if they have an active infection? Patients should not start Humira if they have any kind of infection unless their doctor explicitly approves it. The medication can lower the immune system’s ability to fight infections, making it crucial to address any existing infections before beginning treatment.

Humira and Tuberculosis: Understanding the Connection

One of the most significant safety concerns associated with Humira is the increased risk of tuberculosis (TB). Patients considering or using Humira should be particularly aware of this risk and the necessary precautions.

TB Screening and Monitoring

1. Initial TB testing before starting Humira
2. Regular monitoring for TB symptoms during treatment
3. Potential prophylactic treatment for high-risk individuals
4. Importance of reporting any TB-related symptoms promptly
5. Ongoing communication with healthcare providers about TB risk

Why is TB testing important for Humira users? TB testing is crucial because Humira can reactivate latent TB infections or increase susceptibility to new TB infections. Early detection and treatment of TB are essential for patient safety.

Cancer Risk and Humira: What the Research Shows

The potential increased risk of certain cancers is another important safety consideration for Humira users. While the overall risk remains relatively low, patients should be informed about the latest research and findings.

Types of Cancer Associated with Humira Use

• Lymphoma
• Skin cancer (basal cell and squamous cell carcinoma)
• Hepatosplenic T-cell lymphoma (rare)
• Other unusual cancers in children and young adults

How significant is the cancer risk associated with Humira? While there is a potential increased risk, it’s important to note that the absolute risk remains low for most patients. The benefits of Humira in managing autoimmune conditions often outweigh the risks for many individuals. However, patients should discuss their personal risk factors with their healthcare provider.

Pre-Treatment Considerations: What to Tell Your Doctor

Before starting Humira, it’s crucial for patients to have an open and thorough discussion with their healthcare provider. Sharing comprehensive medical history and current health status can help ensure safe and effective treatment.

Important Information to Disclose

1. Current or recurrent infections
2. History of tuberculosis or TB exposure
3. Travel to or residence in areas with increased fungal infection risk
4. Hepatitis B status
5. Planned surgeries
6. Cancer history
7. Neurological conditions
8. Heart conditions
9. Vaccination history and plans
10. Allergies, especially to latex or Humira ingredients
11. Pregnancy or family planning intentions

How does a patient’s medical history impact Humira treatment? A patient’s medical history can significantly influence the decision to use Humira, the dosage, and the monitoring required during treatment. For example, a history of recurrent infections might necessitate more frequent check-ups, while a history of hepatitis B could require additional liver function monitoring.

Humira and Specific Health Conditions: Tailoring Treatment Approaches

Humira is used to treat a variety of autoimmune conditions, and its effectiveness and safety profile can vary depending on the specific condition being treated. Understanding how Humira interacts with different health conditions is crucial for optimizing treatment outcomes.

Humira in Various Autoimmune Conditions

• Rheumatoid Arthritis
• Psoriatic Arthritis
• Ankylosing Spondylitis
• Crohn’s Disease
• Ulcerative Colitis
• Plaque Psoriasis
• Juvenile Idiopathic Arthritis
• Hidradenitis Suppurativa
• Uveitis

How does Humira’s effectiveness vary across different conditions? While Humira has shown significant efficacy in many autoimmune conditions, its effectiveness can vary. For instance, it may provide rapid relief in conditions like rheumatoid arthritis, while its effects in conditions like Crohn’s disease may take longer to manifest. The dosing and administration schedule may also differ based on the specific condition being treated.

Condition-Specific Considerations

1. Tailored dosing regimens
2. Combination therapies with other medications
3. Monitoring for condition-specific side effects
4. Adjustments based on disease severity and progression
5. Long-term management strategies

Can Humira be used in combination with other treatments? In many cases, Humira can be used in combination with other medications, particularly in complex autoimmune conditions. For example, in rheumatoid arthritis, it’s often used alongside methotrexate for enhanced efficacy. However, the specific combinations and their safety profiles should be carefully evaluated by healthcare providers on a case-by-case basis.

Navigating Insurance Approvals: Strategies for Humira Coverage

Obtaining insurance approval for Humira can sometimes be challenging, given its high cost and the availability of alternative treatments. Understanding the insurance approval process and knowing how to navigate it effectively can significantly impact a patient’s ability to access this medication.

Steps to Improve Insurance Approval Chances

• Thorough documentation of medical necessity
• Detailed record of previous treatments and their outcomes
• Collaboration between healthcare provider and insurance company
• Understanding and following step therapy requirements
• Appealing denials with additional supporting evidence

What role does prior authorization play in Humira coverage? Prior authorization is often required by insurance companies before they will cover Humira. This process involves the healthcare provider submitting detailed information about the patient’s condition, previous treatments, and the medical necessity of Humira. Successfully navigating the prior authorization process is crucial for obtaining coverage.

Dealing with Insurance Denials

1. Review the denial reason carefully
2. Gather additional supporting documentation
3. Consult with your healthcare provider for appeal strategies
4. Consider peer-to-peer reviews between your doctor and the insurance company
5. Explore patient advocacy resources for assistance

How can patients effectively appeal an insurance denial for Humira? Effective appeals often involve providing additional medical evidence, such as detailed treatment histories, test results, and expert opinions. Patients should work closely with their healthcare providers to compile a comprehensive appeal package that clearly demonstrates the medical necessity of Humira for their specific condition.

Long-Term Considerations: Managing Humira Treatment Over Time

For many patients, Humira treatment is a long-term commitment. Understanding how to manage this treatment over an extended period is crucial for maintaining its effectiveness and ensuring patient safety.

Key Aspects of Long-Term Humira Management

• Regular monitoring of treatment efficacy
• Ongoing assessment of potential side effects
• Adjusting dosage or frequency as needed
• Managing concurrent medications and treatments
• Addressing changes in health status or lifestyle

How often should Humira patients have check-ups? The frequency of check-ups can vary depending on the individual’s condition and overall health status. Generally, patients on Humira should have regular follow-ups, typically every 3-6 months, to assess treatment effectiveness and monitor for any potential complications.

Strategies for Long-Term Success with Humira

1. Maintaining open communication with healthcare providers
2. Adhering to prescribed treatment regimens
3. Monitoring and reporting any new symptoms or side effects promptly
4. Staying informed about new research and treatment options
5. Engaging in healthy lifestyle practices to support overall health

Can patients develop resistance to Humira over time? Some patients may develop antibodies to Humira, which can reduce its effectiveness over time. This phenomenon, known as immunogenicity, can vary among individuals. Healthcare providers may monitor for signs of reduced efficacy and consider adjusting treatment strategies if necessary.

Humira and Lifestyle Considerations: Optimizing Daily Life

While Humira can significantly improve the quality of life for many patients with autoimmune conditions, it’s important to consider how it may interact with various aspects of daily living. Understanding these interactions can help patients optimize their treatment experience and maintain overall well-being.

Lifestyle Factors to Consider

• Diet and nutrition
• Exercise and physical activity
• Stress management
• Sleep patterns
• Alcohol consumption
• Smoking habits
• Travel considerations
• Workplace accommodations

How does Humira affect a patient’s ability to exercise? Generally, Humira does not directly limit a patient’s ability to exercise. In fact, many patients find that as their condition improves with Humira treatment, they are better able to engage in physical activities. However, it’s important to start slowly and consult with healthcare providers about appropriate exercise regimens.

Tips for Managing Daily Life on Humira

1. Develop a consistent medication schedule
2. Create a system for tracking doses and side effects
3. Plan ahead for travel, including proper medication storage
4. Communicate with employers about any necessary accommodations
5. Join support groups or connect with other Humira users for shared experiences

Are there specific dietary recommendations for Humira users? While there are no strict dietary restrictions for Humira users, maintaining a balanced, nutrient-rich diet can support overall health and potentially enhance treatment outcomes. Some patients find that an anti-inflammatory diet complements their Humira therapy, but it’s important to discuss any significant dietary changes with a healthcare provider.

Future Perspectives: Advancements in Humira Treatment and Alternatives

The landscape of autoimmune disease treatment is continually evolving, with ongoing research into Humira, its biosimilars, and alternative therapies. Staying informed about these developments can help patients and healthcare providers make informed decisions about long-term treatment strategies.

Emerging Trends in Humira Treatment

• Development of biosimilar versions of Humira
• Research into new indications for Humira use
• Advancements in personalized medicine approaches
• Exploration of combination therapies
• Improvements in drug delivery methods

How might biosimilars impact Humira treatment and costs? Biosimilars, which are highly similar versions of biologic drugs like Humira, have the potential to increase treatment options and potentially reduce costs. As more biosimilars enter the market, patients may have access to more affordable alternatives that offer similar efficacy and safety profiles.

Future Research Directions

1. Investigating long-term outcomes of Humira treatment
2. Exploring predictive biomarkers for treatment response
3. Developing targeted therapies for specific autoimmune subtypes
4. Studying the impact of Humira on the microbiome
5. Investigating novel drug combinations to enhance efficacy

Save on HUMIRA® | HUMIRA Complete

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay.  Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of

unusual

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections.

IMPORTANT SAFETY INFORMATION 

ABOUT HUMIRA^® (adalimumab)¹

What is the most important information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor. HUMIRA is a TNF blocker medicine that can lower the ability of your immune system to fight infections. You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay.

• Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.
• Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.

What should I tell my doctor BEFORE starting HUMIRA?

Tell your doctor about all of your health conditions, including if you:

• Have an infection, are being treated for infection, or have symptoms of an infection
• Get a lot of infections or infections that keep coming back
• Have diabetes
• Have TB or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
• Live or have lived in an area (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections, such as histoplasmosis, coccidioidomycosis, or blastomycosis. These infections may happen or become more severe if you use HUMIRA. Ask your doctor if you are unsure if you have lived in these areas
• Have or have had hepatitis B
• Are scheduled for major surgery
• Have or have had cancer
• Have numbness or tingling or a nervous system disease such as multiple sclerosis or Guillain-Barré syndrome
• Have or had heart failure
• Have recently received or are scheduled to receive a vaccine. HUMIRA patients may receive vaccines, except for live vaccines. Children should be brought up to date on all vaccines before starting HUMIRA
• Are allergic to rubber, latex, or any HUMIRA ingredients
• Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed
• Have a baby and you were using HUMIRA during your pregnancy. Tell your baby’s doctor before your baby receives any vaccines

Also tell your doctor about all the medicines you take. You should not take HUMIRA with ORENCIA^® (abatacept), KINERET^® (anakinra), REMICADE^® (infliximab), ENBREL^® (etanercept), CIMZIA^® (certolizumab pegol), or SIMPONI^® (golimumab). Tell your doctor if you have ever used RITUXAN^® (rituximab), IMURAN^® (azathioprine), or PURINETHOL^® (mercaptopurine, 6-MP).

What should I watch for AFTER starting HUMIRA?

HUMIRA can cause serious side effects, including:

• Serious infections. These include TB and infections caused by viruses, fungi, or bacteria. Symptoms related to TB include a cough, low-grade fever, weight loss, or loss of body fat and muscle.
• Hepatitis B infection in carriers of the virus. Symptoms include muscle aches, feeling very tired, dark urine, skin or eyes that look yellow, little or no appetite, vomiting, clay-colored bowel movements, fever, chills, stomach discomfort, and skin rash.
• Allergic reactions. Symptoms of a serious allergic reaction include hives, trouble breathing, and swelling of your face, eyes, lips, or mouth.
• Nervous system problems. Signs and symptoms include numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
• Blood problems (decreased blood cells that help fight infections or stop bleeding). Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
• Heart failure (new or worsening). Symptoms include shortness of breath, swelling of your ankles or feet, and sudden weight gain.
• Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
• Liver problems. Symptoms include feeling very tired, skin or eyes that look yellow, poor appetite or vomiting, and pain on the right side of your stomach (abdomen). These problems can lead to liver failure and death.
• Psoriasis (new or worsening). Symptoms include red scaly patches or raised bumps that are filled with pus.

Call your doctor or get medical care right away if you develop any of the above symptoms.

Common side effects of HUMIRA include injection site reactions (pain, redness, rash, swelling, itching, or bruising), upper respiratory infections (sinus infections), headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away.

Remember, tell your doctor right away if you have an infection or symptoms of an infection, including:

• Fever, sweats, or chills
• Muscle aches
• Cough
• Shortness of breath
• Blood in phlegm
• Weight loss
• Warm, red, or painful skin or sores on your body
• Diarrhea or stomach pain
• Burning when you urinate
• Urinating more often than normal
• Feeling very tired

HUMIRA is given by injection under the skin.

This is the most important information to know about HUMIRA. For more information, talk to your health care provider.

Uses

HUMIRA is a prescription medicine used:

• To reduce the signs and symptoms of:
  • Moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone, with methotrexate, or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
  • Moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 2 years of age and older. HUMIRA can be used alone or with methotrexate.
  • Psoriatic arthritis (PsA) in adults. HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
  • Ankylosing spondylitis (AS) in adults.
  • Moderate to severe hidradenitis suppurativa (HS) in people 12 years and older.
• To treat moderate to severe Crohn’s disease (CD) in adults and children 6 years of age and older.
• To treat moderate to severe ulcerative colitis (UC) in adults and children 5 years of age and older. It is not known if HUMIRA is effective in people who stopped responding to or could not tolerate anti-TNF medicines.
• To treat moderate to severe chronic plaque psoriasis (Ps) in adults who are ready for systemic therapy or phototherapy, and are under the care of a doctor who will decide if other systemic therapies are less appropriate.
• To treat non-infectious intermediate (middle part of the eye), posterior (back of the eye), and panuveitis (all parts of the eye) in adults and children 2 years of age and older.

US-HUM-210186

HUMIRA® (adalimumab) Savings Card

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of

unusual

IMPORTANT SAFETY INFORMATION

¹

You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay. Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections.

IMPORTANT SAFETY INFORMATION 

ABOUT HUMIRA^® (adalimumab)¹

What is the most important information I should know about HUMIRA?

You should discuss the potential benefits and risks of HUMIRA with your doctor. HUMIRA is a TNF blocker medicine that can lower the ability of your immune system to fight infections. You should not start taking HUMIRA if you have any kind of infection unless your doctor says it is okay.

• Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.
• Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.

What should I tell my doctor BEFORE starting HUMIRA?

Tell your doctor about all of your health conditions, including if you:

• Have an infection, are being treated for infection, or have symptoms of an infection
• Get a lot of infections or infections that keep coming back
• Have diabetes
• Have TB or have been in close contact with someone with TB, or were born in, lived in, or traveled where there is more risk for getting TB
• Live or have lived in an area (such as the Ohio and Mississippi River valleys) where there is an increased risk for getting certain kinds of fungal infections, such as histoplasmosis, coccidioidomycosis, or blastomycosis. These infections may happen or become more severe if you use HUMIRA. Ask your doctor if you are unsure if you have lived in these areas
• Have or have had hepatitis B
• Are scheduled for major surgery
• Have or have had cancer
• Have numbness or tingling or a nervous system disease such as multiple sclerosis or Guillain-Barré syndrome
• Have or had heart failure
• Have recently received or are scheduled to receive a vaccine. HUMIRA patients may receive vaccines, except for live vaccines. Children should be brought up to date on all vaccines before starting HUMIRA
• Are allergic to rubber, latex, or any HUMIRA ingredients
• Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed
• Have a baby and you were using HUMIRA during your pregnancy. Tell your baby’s doctor before your baby receives any vaccines

Also tell your doctor about all the medicines you take. You should not take HUMIRA with ORENCIA^® (abatacept), KINERET^® (anakinra), REMICADE^® (infliximab), ENBREL^® (etanercept), CIMZIA^® (certolizumab pegol), or SIMPONI^® (golimumab). Tell your doctor if you have ever used RITUXAN^® (rituximab), IMURAN^® (azathioprine), or PURINETHOL^® (mercaptopurine, 6-MP).

What should I watch for AFTER starting HUMIRA?

HUMIRA can cause serious side effects, including:

• Serious infections. These include TB and infections caused by viruses, fungi, or bacteria. Symptoms related to TB include a cough, low-grade fever, weight loss, or loss of body fat and muscle.
• Hepatitis B infection in carriers of the virus. Symptoms include muscle aches, feeling very tired, dark urine, skin or eyes that look yellow, little or no appetite, vomiting, clay-colored bowel movements, fever, chills, stomach discomfort, and skin rash.
• Allergic reactions. Symptoms of a serious allergic reaction include hives, trouble breathing, and swelling of your face, eyes, lips, or mouth.
• Nervous system problems. Signs and symptoms include numbness or tingling, problems with your vision, weakness in your arms or legs, and dizziness.
• Blood problems (decreased blood cells that help fight infections or stop bleeding). Symptoms include a fever that does not go away, bruising or bleeding very easily, or looking very pale.
• Heart failure (new or worsening). Symptoms include shortness of breath, swelling of your ankles or feet, and sudden weight gain.
• Immune reactions including a lupus-like syndrome. Symptoms include chest discomfort or pain that does not go away, shortness of breath, joint pain, or rash on your cheeks or arms that gets worse in the sun.
• Liver problems. Symptoms include feeling very tired, skin or eyes that look yellow, poor appetite or vomiting, and pain on the right side of your stomach (abdomen). These problems can lead to liver failure and death.
• Psoriasis (new or worsening). Symptoms include red scaly patches or raised bumps that are filled with pus.

Call your doctor or get medical care right away if you develop any of the above symptoms.

Common side effects of HUMIRA include injection site reactions (pain, redness, rash, swelling, itching, or bruising), upper respiratory infections (sinus infections), headaches, rash, and nausea. These are not all of the possible side effects with HUMIRA. Tell your doctor if you have any side effect that bothers you or that does not go away.

Remember, tell your doctor right away if you have an infection or symptoms of an infection, including:

• Fever, sweats, or chills
• Muscle aches
• Cough
• Shortness of breath
• Blood in phlegm
• Weight loss
• Warm, red, or painful skin or sores on your body
• Diarrhea or stomach pain
• Burning when you urinate
• Urinating more often than normal
• Feeling very tired

HUMIRA is given by injection under the skin.

This is the most important information to know about HUMIRA. For more information, talk to your health care provider.

Uses

HUMIRA is a prescription medicine used:

• To reduce the signs and symptoms of:
  • Moderate to severe rheumatoid arthritis (RA) in adults. HUMIRA can be used alone, with methotrexate, or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
  • Moderate to severe polyarticular juvenile idiopathic arthritis (JIA) in children 2 years of age and older. HUMIRA can be used alone or with methotrexate.
  • Psoriatic arthritis (PsA) in adults. HUMIRA can be used alone or with certain other medicines. HUMIRA may prevent further damage to your bones and joints and may help your ability to perform daily activities.
  • Ankylosing spondylitis (AS) in adults.
  • Moderate to severe hidradenitis suppurativa (HS) in people 12 years and older.
• To treat moderate to severe Crohn’s disease (CD) in adults and children 6 years of age and older.
• To treat moderate to severe ulcerative colitis (UC) in adults and children 5 years of age and older. It is not known if HUMIRA is effective in people who stopped responding to or could not tolerate anti-TNF medicines.
• To treat moderate to severe chronic plaque psoriasis (Ps) in adults who are ready for systemic therapy or phototherapy, and are under the care of a doctor who will decide if other systemic therapies are less appropriate.
• To treat non-infectious intermediate (middle part of the eye), posterior (back of the eye), and panuveitis (all parts of the eye) in adults and children 2 years of age and older.

US-HUM-210186

How much does Humira cost? View prices and ways to save – Product Information

Home >> Product Information >> How much does Humira cost? See prices and ways to save.

Medication Information

Humira is a prescription medicine that reduces the signs and symptoms of arthritis, Crohn’s disease and ankylosing spondylitis. It is a tumor necrosis factor (TNF) blocking drug and is one of the best-selling drugs in the world. Let’s see how much Humira costs, if insurance covers it, and how to save money.

How much does Humira cost?

Humira (adalimumab) is a very expensive drug that costs about $7,389 for two subcutaneous (10 mg/0.1 ml) kits. Two subcutaneous injection kits typically contain a month’s supply of Humira, which means a year’s worth of medication can cost upwards of $84,000.

You can pay less for Humira if you have a discount card or an insurance plan that covers it, but Humira is an expensive drug whether you can find a discount or not. One of the reasons Humira is so expensive is that it is a difficult drug to make. Generating proteins for a drug requires the use of DNA technology, a process that cannot be replicated, unlike synthetic drugs. Humira works by blocking and reducing the action of tumor necrosis factor (TNF), which causes inflammation. People with autoimmune diseases like arthritis or Crohn’s disease produce too much TNF, so Humira is often prescribed.

Humira is a biological drug, which is another way of saying it is made of DNA. Because of this, the FDA requires it to go through extensive research and testing – another reason why it’s so expensive. Manufacturers cannot circumvent FDA requirements; although in theory this would make Humira cheaper for those who need it.

Does insurance cover Humira?

Sometimes insurance plans help cover the cost of Humira, making life easier for those who need drugs. Humira is covered by most insurance plans, but individual plans may vary in coverage. Insurance could reduce Humira’s out-of-pocket cost from about 7,389dollars to about $5,000 per month.

Some people who receive commercial prescription coverage from an employer/retiree will be eligible for a full Humira Savings Card. The Humira Complete Savings card is only available to people who have private insurance from their employer or people who have purchased coverage directly from insurance companies. Copay assistance is not available to people who receive prescription reimbursement through federal, state, or state insurance programs.

Does Medicare cover Humira?

People without private insurance can get Humira at a reduced cost through Medicare or Medicaid. Medicare is the federal health insurance program for adults over 65 and those with certain disabilities. Prescription coverage is available through Medicare Advantage Plans (Part C) and Complementary Plans (Part D).

Medicare Advantage Plans provide coverage for Medicare Part A and B (hospital and medical insurance) and may sometimes cover prescription drugs. Medicare Part D can be added to Medicare Parts A and B for additional prescription drug coverage.

Most Medicare plans list Humira as a Tier 5 drug because it is a specialty drug and Tier 5 drugs usually cost more than Tier 1-4 drugs. Because Medicare lists Humira as a Level 5 drug, most people will need Medicare Part D in addition to Medicare Part C, but some Part C plans may cover Humira on their own.

Some people with Medicare coverage will be eligible for Extra Help, which can also lower the cost of Humira. Eligibility for this subsidy is determined by Medicare and cannot be combined with a full Humira Savings Card. You can visit medicare.gov or call your Medicare card number to find out if you qualify for Extra Help.

Does Medicaid cover Humira?

Medicaid works a little differently than Medicare. It is operated by the federal government and the individual states and provides health care to low-income individuals and families. Although pharmacy coverage is an optional benefit under federal Medicaid law, some state Medicaid programs may cover the cost of Humira, but coverage will vary from state to state. Visit medicaid.gov to learn more about Humira coverage depending on where you live.

The best way to find out if your insurance covers Humira is to check your individual insurance plan. Your insurance company’s website may provide you with the information you need, or you may need to call your insurance company directly. Humira’s website, humira.com, also has great resources, and they even have insurance specialists you can call to see if your Humira insurance covers.

4 ways to save money on Humira

To get the best deal on Humira, it may take a little research to make sure you’re saving as much as possible. Here are five of the best ways to get Humira for less.

1. Insurance

Taking advantage of your health plan’s benefits is one of the best ways to save money on Humira. As mentioned earlier, some insurance plans will cover the cost of Humira or reduce your out-of-pocket costs. Individuals with private insurance may be eligible for a full Humira Savings Card. Medicare and Medicaid may also lower the cost of Humira depending on your individual plan and/or where you live. However, it is not possible to be a member of Medicare, Medicaid, Medigap, TRICARE, Medicare Advantage, or Veterans Affairs and receive a full Humira Savings Card.

It’s important to note that most insurance plans will require you to complete a prior authorization form or step therapy before they will agree to cover the cost of Humira. The Prior Authorization Form is a confirmation of coverage from your insurance company that is used to confirm that the drug you are getting is the most appropriate and cost effective drug. The step therapy process requires that other drugs be tried for a certain amount of time before switching to Humira. This ensures that potentially cheaper drugs for your particular condition are tried first. Restrictions can make it difficult to get coverage for Humira, but you can always ask your doctor to file an appeal if your insurance doesn’t cover Humira.

2. Humira coupons

Using coupons can be a great way to pay less for Humira. AbbVie Inc., the manufacturer of Humira, offers a complete Humira savings card, but not everyone is eligible for this savings card. For those who are not eligible, using an online coupon is a great second option. If you use the SingleCare Coupon for Humira, you could pay $5,273 instead of $7,389 for each box of prefilled syringes. Similar online coupons can be used at participating pharmacies such as Walgreens, Rite Aid, Walmart, CVS, and more.

3. Manufacturer discounts.

Sometimes pharmacies don’t accept a full Humira savings card, which can leave you with a large bill. You can still save money on Humira by taking advantage of Humira’s full prescription discount. Discounts are only available to people with commercial prescription coverage or self-insured patients. If you meet these requirements, you can get receipts from Humira and receive a discounted check from Opus Health. If you want to learn more about how to save money on Humira with discounts, visit the manufacturer’s website.

4. AbbVie Patient Assistance Program

Unemployed or underinsured patients may be eligible for the AbbVie Patient Assistance Program. This program provides free assistance to those who meet certain income criteria. The program is free to apply, and those who qualify receive their medications free of charge. Visit the AbbVie website to see if you qualify for Humira for free.

Is there a universal version of Humira?

Generic versions of brand-name drugs are often more affordable to consumers. Unfortunately, there are no Humira generics or biosimilars on the US market that can be bought at a lower price.

Since 2002, AbbVie has carefully developed patents to ensure that Humira is protected from biosimilar competition. In 2016, Amgen launched a drug called Amjevita, which was the first Humira biosimilar to receive FDA approval. Amgen won the right to launch its biosimilar in Europe in 2018 and will release it in the US in 2023. The following list of Humira Biosimilars will be available in the US in 2023:

• April by Pfizer
• Amjevita by Amgen
• CHS-1420 by Coherus BioSciences
• Cyltezo by Boehringer Ingelheim
• Hadlima by Merck / Samsung Bio epis
• Hulio by Mylan
• Hyrimoz user Novartis / Sandoz
• MSB11022 – User Fresenius Kabi

Until the release of biosimilars made by other pharmaceutical companies, US citizens will still have to buy Humira at full price if it is not covered by their insurance or if they cannot get it at a lower price.

There are other prescription drugs on the market that can treat rheumatoid arthritis, Crohn’s disease, hidradenitis suppurativa and other conditions that Humira treats. However, since these other drugs are biologics, they will be similar in price to Humira. If the side effects of Humira become too much for someone, they may need to consider taking another medication. Here are the most common Humira side effects to be aware of:

• Headaches
• Rash
• Nausea
• Injection site reactions
• Urinary tract infections
• Upper respiratory tract infections in the back

Those interested in Humira alternatives can talk to their doctor about the following options.

The appropriate biologic to prescribe depends on the unique situation the patient and other factors such as medical history, duration of the condition, severity of the condition, past medical procedures, and treatment goals. Anna H. Chacon, M.D., board certified American dermatologist from South Florida.

That’s why it’s important to talk to your doctor about whether Humira is right for you. Your doctor will be able to give you medical advice that is right for you and can also help you find ways to save money on your Humira prescription.

The “battle for Humira” in the US is postponed until 2023, and in the EU it is in full swing

While quotas are being divided in Europe for the operational space opened after the loss of market exclusivity of Humira (adalimumab) 900 03 , in In the United States, AbbVie managed to delay its entry into the generic market until the end of 2023!

“ Amgen ” – European and American Race Leader

In the final months of 2018, AbbVie closed deal after deal, negotiating delayed launches. The company “ Amgen ” has been the most successful in both the American and European markets. Thus, she was the first to settle the issue of generic competition with AbbVie and received the most favorable conditions: the launch of a biosimilar product on January 31, 2023. Among those granted marketing authorization in the EU, 8 biosimilars from 5 different manufacturers. Amgen with Amgevita is also ahead of the curve (authorization date March 21, 2017).

Only one company disagreed with AbbVie…

However, the European market generated only $4.4 billion for AbbVie in 2017. United States, while the American – 12.36 billion dollars. (according to IQVIA), therefore, apparently, the decision was made to sacrifice little in order to save more. Only “ Boehringer Ingelheim” does not give up and is going to compete with Humira for a place under the American sun for its biosimilar Cyltezo . Having decided not to even bring a European Medicines Agency (EMA)-approved drug to the European market, Boehringer Ingelheim is looking for gaps in the American legal armor of the world’s best-selling drug.

Sandoz completes today’s series of generic companies admitting defeat in America’s “battle for Humira”. Prior to her, Mylan, Fresenius Kabi, Momenta and Pfizer signed agreements with AbbVie to postpone the launch, Pharmaphorum notes. In accordance with the timing of the conclusion of transactions, the time of the onset of “hour X”, when one or another company will be able to launch, is also distributed. So, “lucky” “ Amgen ” can start on January 31, 2023, and “indecisive” “Sandoz” – only in September of the same year .

Insurers still have time to save, but for now…

How are generic companies doing with market penetration? At first glance, the health insurance system, represented by its representatives, should be most interested in switching to biosimilar drugs in order to save money. However, everything is not so simple here either: , some insurers in Germany, for example, have entered into discount agreements with manufacturers of original drugs, and on this basis do not adhere to the biosimilar prescription quotas recommended at the level of the parent organization, for example, KBV, under whose wing 70 million Germans are treated. The originator company has differentiated approaches in different European markets, providing discounts from 10 to 80%, according to Reuters.

NHS saves on command

The National Health Service (NHS) of Great Britain, being a centralized system, immediately calculated the benefits of biosimilar replacement. For example, NHS is set to save £300 million ($386 million) by entering into agreements with several manufacturers of the biosimilar adalimumab (Amgen, Biogen, Mylan/Fujifilm Kyowa Kirin and Sandoz).

Before this agreement, NHS England spent more per year on Humira (adalimumab) than on any other drug, and the deal, which also included a discounted price offer from AbbVie, represents the largest savings in drug negotiation history. The NHS said in a statement that the equivalent of the savings would allow for an additional 11,700 nurses or 19800 cases of breast cancer.

By the end of 2018, over 46,000 patients with rheumatoid arthritis, Crohn’s disease, ankylosing spondylitis, psoriatic arthritis, and others were treated with Humira.