I did go back on prednisone, but only 25 mg (two and half pills) instead of the 40 mg (four pills) the doctor recommended and it is doing its job. I'm swinging back up. (Up and down, up and down, up and down, up and . . . well, you get the picture. )
In my December health update, I said that my G.I. doctor wanted me to go on Rinvoq, a fairly new medicine only recently approved for ulcerative colitis. Well, my insurance denied it. They want me to go on Humira or another biologic first. They call it step therapy.
What is step therapy? According to healthinsurance.org, it is "a program that requires patients to try a lower cost prescription drug that treats a given condition before 'stepping up' to a similar-acting, but more expensive drug. Step therapy is a very common cost-control strategy. Step therapy generally saves money for both the patient and the health plan."
I get it. Insurance companies are trying to keep costs down, which we all appreciate. (But do they pass on those cost savings to us or . . .) There are a lot of things about this condition "I get." But that doesn't mean it isn't frustrating. My doctor thinks a certain medicine will help, but he can't prescribe it because of insurance limitations. Arghhh . . .
The options we talked about at my last appointment were going on Rinvoq, Humira, or the doctor mentioned another medication to try, azathioprine. Or he could choose to fight the insurance. I left a message with my his office over a week ago asking what next steps we should take, but I haven't heard back. Thank goodness I have the prednisone in the meantime!
I will add another update to this post once I hear from my doctor and we decide whether to go to the next step or fight the dragon.
JANUARY 21 Update:
I haven't heard from my doctor yet, which I'm taking to mean he's waiting to hear back from the insurance company. The prednisone is working, and I am doing much better. I tapered down to one pill a day (10mg) this morning. Thanks goodness the prednisone is keeping me fairly normal until we get this all figured out.
Next Update: February 2023, A Surprise
Previous Update: December 2022, And The Next Medicine Coming Up to Bat is . . .
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