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what would you do?

luvbostonluvboston member
in Infertility Veterans
The repro immunologist suggested that I take Humira for my high TNF I agreed but said that we were going to need assistance paying for it as at the same time we have to have LIT (2x) which is $600 a pop plus all the travel expenses. So they suggested Abbott Patient Assistance and said it would take 3days to get an answer well I am 1 month in and still they are screwing around and keep asking for my insurance to file an appeal, my insurance does not cover Humira except for RA, they hardly cover my PIO when I am pg. I have tried to tell the case manager that they will not file an appeal and my doc has also spoken to them and is now trying to force the insurance company to send Abbott a letter. Tuesday is the deadline for me to take the first Humira shot in order to cycle at the beg of Feb we were supposed to do an IUI 3 weeks after the last shot and 5 weeks after the LIT. Do you think I should just break down and pay the 2k for Humira or do you think I should give up hope on this cycle and fight it out with Abbott risking my immune system possibly misbehaving while we wait the extra month? 
6 m/c
Anovulatory cycles, increased Synthroid Diagnosed Sep 2010
Natural cycle Dec 2010 BFP M/C 6 1/2 Weeks, D&E Jan 2011
1 Clomid/Ovidrel BFN May 2011
Natural cycle Aug 2011 BFP M/C 4 Weeks
1 IUI Sept 2011 BFP M/c 7 weeks
Provera Dec 2011 BFP M/C 3 Weeks
DQ ALPHA HLA MATCH, High NK Cells Diagnosed Dec 2011
IVF March 2012 BFP m/c 4weeks 5 days (IL, Prednisone)
IVF#2w/DS July 2012 MEGA FAILURE BFN (IL, Dexamethasone)
Diagnosed No real HLA Match, DQ Beta Triad, High TNF, Low NK Cells
Oct 2012 Natural Cycle m/c 4wks (Lovenox, Prednisone) 
Went to Beer Center- high tnf, low lad, implantation failure
Nov/Dec 2012 LIT Treatment
Dec 12 Humira
Jan 2013 BFP
Humira,LIT,Prednisone, Lovenox, IVIG, Baby Aspirin
Miracle Born August 2013 Premature

Yours doesn't have to be a sad story


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Lilypie - (ugiy)


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Re: what would you do?

  • Mrs.McIrishMrs.McIrish member
    I just googled the application and it says you have to submit proof of income. Not sure what level they cut off at but they also want the doctor to fill out the diagnosis code. IF is not listed obviously. It is RA and Crohn's disease. There is an"other" box but i wonder if the manufacturer would give away the drug for IF treatment if it really wasn't created to treat IF issues initially.  I'd hate you to wait and still have them deny you due to eligibility requirements.. 

    TTC #1 since 8/1/10; Me:41 and BRCA1+, DH:46
    DOR (FSH 24.3)/ terrible egg quality ; homozygous MTHFR c677t
    5 IUI's: 2/11 to 6/11 and 1/12= BFN
    OE IVF#1-4 8/11-6/12= all BFN
    DE IVF#1 11/12 bad embryos= BFN
    DE IVF #2 2/13 BFP/Beta hell: m/c 5w6d
    CFNBC 7 months, not doing well; decided on guarantee program at RBA w/frozen DE
    DE IVF #3 1/14  ET 4BB; BFP;M/C 5w1d, incomplete m/c; MVA extraction in ER 7w1d

    DE FET#1 ET 3/1714; BFP, beta 1 3/27= 197, beta 2 3/31= 1586, beta 3 4/7= 13879!!
    First u/s= Twins with HBs at 6w2d! We are Team Pink x 2!!

    K & K born 11/21/14 at 38wks 4 days

    imageimage

    SAIF/PAIF Welcome


    http://waitingforraintostop.wordpress.com

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  • kmc84kmc84 member

    ticker warning........

     

    Has your doc considered other TNF inhibitors, like Enbrel or Remicade, or does he want you to stick with Humira?  Maybe you would have better luck with another company for assistance. The costs of those drugs are unreal. Does your doc have any drug samples to get you started?

    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    TTC# 1 since 5/10
    Me:34 Type 1 Diabetes, Ankylosing Spondylitis, Hypothyroid DH:35 Perfect
    DX: Unexplained IF
    Many IUI's with various meds all BFFN
    IVF #1 11/11 canceled due to OHSS
    IVF #2 Feb/March 2012 ET of 2 on day 3 4/7 BFP! 5/1 u/s blighted ovum
    IVF #3 July 2012 ET of 3 on day 3 7/24 BFP!
    Healthy baby girl born at 36w4d on 3/9/13
    Baby Birthday Ticker Ticker
    TTC #2
    IVF #4 May/June 2014 ER 6/4 18R 8M 8F ET 6/9 1 blast, 2 frosties
    Beta 6/18 BFFN

    FET of 2 blasts 7/24...BFP!
    Healthy baby girl born at 36w3d on 3/17/15

    TTC#3
    IVF #5 June 2018- PGS planned, no surviving embryos
    IVF #6 August 2018- ET of 2 on day 3 - Chemical pregnancy
    IVF #7 August 2019-....?
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  • PrettyAccountantPrettyAccountant member

    imageMrs.McIrish:
    I just googled the application and it says you have to submit proof of income. Not sure what level they cut off at but they also want the doctor to fill out the diagnosis code. IF is not listed obviously. It is RA and Crohn's disease. There is an"other" box but i wonder if the manufacturer would give away the drug for IF treatment if it really wasn't created to treat IF issues initially.  I'd hate you to wait and still have them deny you due to eligibility requirements.. 

    This exactly - I doubt the manufacturer would get in to a situation where they give away the drugs when it may not be FDA approved for that reason. I hope your situation resolves (in your favor) very soon.

    TTC 1/2010 DH Dx - Azoospermia 2/2011
    Hysteroscopy 3/2011 2 Polyps removed 4/2011
    DH on Clomid / Arimidex to address hormonal issues - Sperm found July 2011!
    IVF #1 September 2011 - ER 9/8/2011- 8R, 5M - icsi - 1 made it to transfer - BFFN :-(
    IVF #2 Lucky November 2011 - ER 11/25/2011 - 15 eggs!, 13 mature, 10 fertilized with isci - 7 made it to transfer! Transferred 1 - 8 cell and 2 - 7 cell. BFP!!!!
    1st U/S - Twins! 2nd U/S - 3 heartbeats!!! - HOLY COW!!!
    Prayers for our take home babies!
    2 babies born on 3/27/12 and lost. Last baby born on 3/29/12 and lost at 20 weeks.
    My angels grew wings shortly after birth.
    Ahava Raisel, Matisyahu Nissim & Zev Chaim - Mommy and Daddy will always love you.
    IVF #3 July 2012 - ER 7/17/2012 - 10 R. 5 F. 4 made it to ET
    Transferred 2 on 7/20/2012 no snow babies :-(
    Beta on 7/31/2012 = BFMFN
    A miracle gift expected to come to us through adoption around 9/2012
    Baby girl adopted - Birth Mother changed her mind and took the baby back
    IVF #4 October 2012 - New RE. Doing PGD Testing. 8 R, 7F, 2 made it to 5 day blast for PDG testing. Both Normal (Thank you G-d!!!) 1 boy and 1 girl
    transferred one beautiful 5day blast (girl)
    Please G-d the almighty one - let this be our take home baby!
    Beta #1 158, Beta #2 318, 1 Absolutely magnificent HB at 175! Thank you G-d!!!
    Baby Girl born August 5th. Thank you G-d for our precious miracle.
    AMA. PAIF & SAIF always welcome - I need all the prayers I can get!

    Lilypie Angel and Memorial tickers
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