Biologics for RA: Costs and Insurance
Biologic drugs for rheumatoid arthritis work for 2 out of 3 people who take them for RA. These genetically engineered drugs often slow or halt the progression of joint damage, and they may even push RA into remission. But the drugs are expensive; they cost about $1,000 to $3,000 a month. Even with health insurance, your out-of-pocket costs can add up to hundreds or thousands of dollars.
Here’s what you need to know about paying for biologics if your doctor wants to add one to your RA treatment plan.
Pick the Right Biologic for You
There are nine biologics available for the treatment of RA. Each type targets a specific inflammatory mechanism of the immune system. Some are given as an injection -- a shot under the skin -- others are given by infusing it directly into a vein (IV or intravenously). These drugs can be used alone but are often combined with methotrexate or other RA medications.
|Drug Name||Brand Name||How it is Given||How Often|
|Abatacept||Orencia||IV or injection||IV: Once a month; injection: once a week|
|Adalimumab||Humira||injection||Weekly or every other week|
|Certolizumab||Cimzia||injection||Once every 2 to 4 weeks|
|Etanercept||Enbrel||injection||Once a week|
|Golimumab||Simponi||IV or injection||IV: Every 8 weeks; injection: once a month|
|Infliximab||Remicade||IV||Once every 4 to 8 weeks|
|Rituximab||Rituxan||IV||Two doses, two weeks apart about every 6 months|
|Tocilizumab||Actemra||IV or injection||IV: Once a month; injection: Weekly or every other week|
Biologics are used to treat RA when methotrexate has failed. If one biologic doesn’t work, your doctor will try another one. It may take some time to find the best drug for you.
The other factor to consider when choosing or switching drugs is side effects. With all of the biologics, you are at increased risk of serious infection.
Do You Prefer a Shot or IV?
Biologics can be given as an injection or intravenously (IV). You and your doctor will want to consider what is best and most convenient for you when choosing a biologic.
You give yourself a shot at home -- convenient, but some people are uneasy about giving themselves a shot.
You may be able to go to your doctor’s office to get the shots.
Must be given at a hospital or clinic.
Risk of injection site reactions such as rash, burning, or itching.
Kineret had the highest rate of injection site reactions, according to an analysis by Consumer Reports in 2010.
Risk of infusion reactions including itching, hives, rash, nausea, and headache.
Rituxan had the highest rate of infusion reactions and Orencia the lowest, according to the 2010 Consumer Reports analysis.
Shots are needed more frequently than infusions.
Frequency ranges from daily shots to a shot every month.
Infusions can take several hours but are usually only needed every month or two.
Infusions may be needed more often during the first year of treatment, which can increase initial costs.