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Wednesday, January 8, 2014

My Rheumatoid Arthritis Story - Part 3

I started asking around for rheumatologist recommendations and everyone kept mentioning a certain doctor at Carilion. I called them and asked for an appointment. I was told said doctor was not taking any new patients and I needed a recommendation before any doctor from Carilion would see me. I became discouraged. My pain was increasing so I called Dr. DoNothing's office and asked if there wasn't anything I could do for it. The nurse said no, my only option was Enbrel. "If a family member of mine was in your situation I would make sure they got on Enbrel."

Why were they pushing Enbrel so much? Even Enbrel's own literature stated that it was only to be used for moderate to severe cases. I really didn't feel like I had a severe case. My husband's aunt has RA and she has a very severe case. She's had many surgeries and you can see the nodules on her. She takes gold. When I was first diagnosed I called her to ask what I could expect. She asked me what "number" I had. I told her 14. 14?! She said that was barely RA...her numbers were up in the 400's! She smoke, she drank, and told me she never let it get in her way. Sure, she had really bad days, and sometimes she didn't want to be around people, but she said that is was okay to feel that way too. I asked her about Enbrel and she said even in her condition she wouldn't risk it.

I started doing more research on Enbrel and everything I read I didn't like. Now that's not to say that it isn't a Godsend for some people, but there was just something about my doctor's insistence that Enbrel was my only option that didn't sit right. I began to wonder if perhaps doctors got some sort of kickback or something so I did a Google search. Lo and behold I found all these articles that Amgen, the maker of Enbrel just recently had to pay $762 million in an illegal drug marketing scam.

From the article: "Amgen also found itself on the wrong side of at least 10 whistleblower lawsuits. “For instance, two former Amgen sales representatives alleged that they were directed by management to promote Enbrel for mild psoriasis even though it had only been approved for more severe forms of the skin condition,” Ankin writes. “Some of the whistleblower lawsuits also included allegations Amgen paid kickbacks to doctors who prescribed the drugs for off-label uses.”

Other articles and blogs were just as disturbing. Amgen reps instructed to poach medical records? What? Even with all the fines, etc. the parent company continues to make money, as stated in this article from October 2012, banking on Enbrel -- "Analyst Steve Brozak of WBB Securities said he's concerned Amgen depends so much on Enbrel, which is in an "exceedingly competitive" market. The drug provides about 25 percent of Amgen's total revenue and one-third of its sales in the U.S., where he expects insurers to start pushing back against the high prices of biologic drugs.

Enbrel and rival medicines such as Remicade and Simponi work by tamping down the immune system to control disorders including rheumatoid arthritis and plaque psoriasis. But they leave people open to infections and possibly unforeseen consequences after long-term use, Brozak said."

Amgen's stock price when that article was written in October 2012 was $89 a it's trading at $116.64. How much does Enbrel cost if you have to use a pen injector prefilled with 50mg, once a week? According to this Consumer Reports $2,690 per month! That's $32,280 per year! I'm not certain how much the insurance would cover. My plan covers 40% so let's go with that number. It would have cost me over almost $19,368. How much did my Methotrexate cost me per year? With insurance $180. If I didn't have insurance it would have been $443.88. If my numbers are close, there's no way I would have been able to afford it anyway.

Now, I'm not saying this particular doctor is getting any sort of kickback or anything, but if he's insisting this is my "only" option I am saying, I will find another doctor for another opinion. It was time to visit my family physician again...

*To be continued...*


  1. Health care in Roanoke is awful. I am trying to get into UVA and even that has become a challenge. My husband is ready to drive me to ER in Charlottesville in hopes of finding someone with some answers - or who might even care. I am pretty sure the doctors in Roanoke don't care if I live or die. Good luck, I will be looking for the next installment of this.

  2. Anita, since I hadn't heard anything I thought your problem was "solved." Dayum that's going a while now, isn't it??? Sorry to hear that. My next installment was put on hold since the letter "U" key stopped working on my laptop. Hope to get to it on Monday...