Dear Ms. Meniscus,

I’m a self sufficient 65 year old woman who’s been self injecting for my arthritis for a few years. Now my doctor says I have to get infusions and change medication because Medicare is paying. What can I do? I don’t want to drive to the hospital infusion center.

– Independence Compromised

Dear Independence Compromised,

You must have recently turned 65, so I believe a “Happy Birthday” is in order!

Unfortunately, your birthday present from the Centers for Medicare and Medicaid Services (CMS) is a policy to force you off of your auto-injectors and start infusion therapy once you turn 65 unless you pay a high co-pay. Depending on where you are located and how mobile you are, this policy can be extremely problematic for you. The reason your co-pay increases dramatically is because under private insurance the pharmaceutical company subsidized your co-pay. Under Medicare they are not allowed to do this. The term for this situation is called “co-pay equity,” but we call it co-pay inequity.”

We here at CreakyJoints are strongly opposed to this policy that forces arthritis patients, such as yourself to become dependent on an infusion clinic when your auto-injectors are working for you. Your physician and you should make the decision together about how to best treat your arthritis, not some government agency that’s only focused on the bottom line rather than your treatment. This one-size-fits-all mentality is unacceptable when it comes to treating patients with a myriad of reactions to different treatment options.

The good news is that policies like this can be changed. One of the most effective ways to generate this kind of change is to write a letter to your to congressperson. Let me know if you need any help finding your representatives, and keep us updated!

And, please don’t misinterpret our feelings about Medicare. We think it is the best health program in the U.S. for all of us who aren’t millionaires and billionaires and can afford anything we want. Medicare efficiently serves millions of people every day. This co-pay equity issue though needs fixing.

In the meantime, find out how much you will have to pay to stay on your self-injection protocol. If it is too much, then please go to the infusion center. Do not stop your treatment. Biologics have changed the world for people with RA but they do not cure it. They only stop it from progressing. And let me know if you want to become a spokesperson to help change this inequity.

Good luck.


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