Taken off Humira. Do I have any recourse?

I have been taking Humira for Psoriatic Arthritis for roughly 7 years with great success. Unfortunately, due to the patent for Humira recently expiring, my insurance company is removing coverage for Humira and forcing me to switch to a similar formulation of the drug called a “biosimilar” due to lower costs.

The problem is, my rheumatologist told me the “biosimilar” versions of Humira aren’t as similar as you might think. There is a chance the new drug will not provide adequate relief which could result in a rebound of symptoms to the extent that I am unable to care for myself. Prior to Humira, my autoimmune disease was so bad I couldn’t lift a gallon of milk, button a shirt, cook etc.. I fear going off Humira could result in unemployment and a host of other issues. These drugs take 3-6 months to work, so if the biosimilar doesn’t work and I need to try an entirely new drug, my symptoms will rebound in full force for months.

Do I have any recourse? If there is a way to appeal the decision to remove coverage, what is the best course of action?

submitted by /u/DynamicDuo2020
[comments]

See also  Contractor Q: Should I set up my own company to get insurance?