This part wasn’t as easy as Enbrel Support thinks it is or as easy as they want you to believe it is. So basically, Enbrel has a group called Enbrel Support and their function is to well, support Enbrel patients and doctors. They tried, I mean they really did, but there are so many pieces to this puzzle that it is not as straightforward as one would think. I’m going to jump around a little, in an attempt to cover it all.

Let’s start with the Co-Pay card. So Enbrel is an expensive medication, around $5k per dosage expensive. So they have this discount co-pay card to help bring your out-of-pocket cost down. So in my case, I have great insurance (Federal BCBS for Federal Employees) and they cover all but $65 of the cost of an injection, and with the co-pay card, that is dropped down to $5, which is a pretty sweet offer. I’m not sure yet, how much my insurance company actually had to pay, as I’m sure BCBS has negotiated a nice price discount already, but I’m not complaining at $5. The problem is getting to this point. The Co-pay card group was thinking that my insurance is a Government funded insurance plan, which means that I’m not eligible for the Co-Pay card. But my insurance isn’t Government funded insurance, but it does have Federal Government in its title (BCBS Federal Government Plan), which is one of the insurance plans you can choose if you work in the Federal Government. It must have been this person’s first day or week on the job, as I’m positive that BCBS Federal isn’t a rare insurance plan. But I move on for the sake of not boring the crap out of you.

So my co-pay card was declined, which meant I had to pay the $65 price. I was still working with Enbrel Support when the Specialty Pharmacy started to pipe in. Now Enbrel is only filled by a Specialty Pharmacy as it is a refrigerated medication and must remain cold, So the Pharmacy is really chomping at the bit to get this shipment sent to me (so they can be their obligation), so I agree to pay the $65 for this month and we will see what shakes out next month. So I get billed for $65 and they tell me that they will overnight the prescription and schedule it to make sure someone is going to be home to receive the shipment.

At the same time, the Enbrel nurse (Enbrel assigns a nurse to your case to help you if you have any issues with your injections to include training and such), is calling me to make sure I have everything I need for my first injections. I told her that my first dosage is on the way and she tells me what to expect and ensures that I can inject it on my own.

I mean my phone was really ringing today. I think I got 4-5 calls from Enbrel Support, 2-3 from the Specialty Pharmacy, and 2 from the Enbrel Nurse. So they were all really trying to get this to work out.

Essentially, I had to have my doctor send another pre-authorization, and then it would all magically work itself out, which it did. The very next day I got a call from Enbrel Support telling me that they have my copay card approved and it will be in the mail.

Over the next few days, I received my refrigerated box of Enbrel, my Enbrel co-pay card, and a ton and I mean a ton of papers telling me how to inject and all the safety warnings. They must have some great lawyers as there were a ton of “cover our butt” papers in each and everything I received from Enbrel.

So, here are all my pros and cons on what I have learned about Enbrel (this does not cover the actual medication and how it works.

1. Enbrel Support is awesome, I just wish that the person who told me that I was declined had half a clue
2. My Enbrel nurse is totally awesome, she calls to check on me and has given me some great advice
3. The shipment was cold and packaged securely and I can’t complain about that
4. The whole copay process is somewhat painful and it really doesn’t have to be that way
5. The Specialty Pharmacy did exactly what it said it would
6. I wish they would have included a sharps container (thank my nurse for hooking me up) and some alcohol wipes, I mean you are shipping $5,000 worth of medication, and you couldn’t provide a sharps container and wipes? I’m told I don’t need a sharps container, but I feel much better using it than just tossing them in the trash
7. Enbrel needs to make a video that fully describes some of the precautions that you need to be aware of like open sores and infections