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Paying for Biologics to Treat Crohn's: Where to Find Help

A biologic drug can ease your Crohn's symptoms and help you stay disease-free for a long time. And it can cost you a lot of money. 

If your doctor suggests a biologic drug to treat your Crohn's disease, don't rule it out because of the price. You may be able to get help to pay for it.

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Low-Residue Diet

If you or a loved one has been diagnosed with an inflammatory bowel disease (IBD) -- like Crohn's disease or ulcerative colitis -- or diverticulitis, your doctor may suggest you follow a low-residue diet. A low-residue diet involves eating more easily digestible foods. A low-residue diet may reduce symptoms of IBD, such as diarrhea and stomach cramping; however, it will not cure IBD.

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Biologics are hard to make, and that drives up the price. One year of treatment can add up to about $20,000. Even if you have health insurance, you may have to pay 25% to 35% of the cost of the drug.

Programs That Help Pay for Biologics

Many drug companies and private groups offer programs that provide drugs at low or no cost. These resources may help you or refer you to a group that can:

The Chronic Disease Fund can help cover the cost of your drug copayments if your health insurance pays very little of the cost.

NeedyMeds can fill you in on more than 2,400 drug aid programs. You can find out which help pay for each type of biologic used to treat Crohn's disease. NeedyMeds also provides a list of state-sponsored programs and discount drug cards.

The Partnership for Prescription Assistance has the facts on more than 475 public and private programs that offer lower-cost or free drugs, including more than 180 drug company programs.

The Patient Access Network Foundation can help you pay for out-of-pocket costs, including drug copays, if your insurance payments are too low.

Rx Assist has a file of patient aid programs, as well as a list of drug discount cards.

The Crohn's & Colitis Foundation of America can provide other sources.

"Generic" Biologics?

In general, when your doctor prescribes a drug or you buy one without a prescription, choosing a generic version can save you money. This is because when a drugmaker's patent expires, another company can produce a generic version of the drug without paying the early costs to research and create it. These drugs have the same active ingredients, but they cost less.

The company that creates a biologic has the sole right to make it for 12 years. After that, other companies can make versions very much like it. But with biologics, this is more complex.

Unlike chemical-based drugs, biologics are made from living sources. That makes it harder to prove that generic versions are as safe and work as well as the first one. Drugmakers will likely have to invest in costly studies to prove their new products are as good. So you may not save much with these types of drugs.

In Europe, where generic biologic drugs are already on the market, people with Crohn's save only about 25% to 30%. It may be a few years before it's clear how much people in the U.S. might be able to save.

WebMD Medical Reference

Reviewed by Arefa Cassoobhoy, MD, MPH on December 29, 2013

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