So on my way over to the rheumatologist’s office to pick up my Xeljanz samples, my specialty pharmacy called me and said that my real prescription was ready to be picked up. I was expected a two-week supply from my doctor and was pleasantly surprised to find a full 30-day bottle. (This was on Friday.) So, after picking up the prescription, I have 60 days in stock plus the two-week sample from the company that arrived yesterday (Tuesday).
Then Friday afternoon I got a letter from my insurance company saying that my authorization had been denied because I hadn’t been through the step therapy program of Humira and Enbrel before going to Xeljanz — which I had but on a different insurance. I’m reasonably intelligent and I”ve dealt with insurance and doctors so my head was telling me that pharmacies just don’t pass out expensive drugs unless they’ve cleared the insurance hurdles. But emotionally it felt like quite a blow because it seemed like I had already spent so much time trying to sort everything out.
So Monday rolls around and I’m trying to figure out who to call first — the pharmacy, the insurance company, or my doctor. Fortunately, Monday afternoon brought a second insurance letter stating that my doctor had already provided the information and that the drug, in fact had been approved.
But wait there’s more.
Tuesday, the people from Xelsource call me. Xelsource is Xeljanz’s patient support arm. They confirmed that everything had been approved, touched base on the co-pay card, and informed me that Pharmacy X would be mailing me my prescription. I thanked them, but I told them that I had already picked up my prescription from my regular specialty pharmacy, and they said, “Fine.”
Today the people at Pharmacy X called me. They needed to clarify something and were more than a bit surprised to learn that I had already picked up the Xeljanz from another pharmacy and, as such, my insurance surely wouldn’t approve a second prescription. I told them I didn’t know how duplicate prescriptions got sent/approved, but that I have an appointment with my rheumatologist in May and that I would ask about it.
So first I couldn’t get a supply of Xeljanz for love or money and now I have people falling all over themselves making sure I have more than enough.
I’ve only been on the drug for a few days so it’s too early to know if there are any positive effects. I had some stomach issues over the weekend which was a bit troubling since that’s one of the known side effects of Xeljanz. However, I’m also taking an NSAID and prednisone and about six other medications, most of which can cause stomach upset. So even with the Protonix I take, it’s not surprising that my tummy rebels a bit.
So that’s where we are. I have enough Xeljanz to see me through the trip and hopefully everything is established so there won’t be issues going forward getting the prescription filled.
I hope whatever adventures you have going on are wonderful. Thanks for checking in.