How much is too much for medication?

Remember how I talked about the insane costs of Enbrel? I mentioned the potential for insurance fuckery in this delicate little house of cards, and as it turns out.. Yeah, a light breeze came in.

I got lucky, though; This time the pre-insurance cost was under $8k, so I only received a bill from the specialty pharmacy for about $330 USD for last month's dose.

When I got that bill, my heart went just a little.. Nuts. I immediately set out to research what happened.

I checked Accredo's portal. I checked BCBS's portal. I checked the scant documentation BCBS provides on my insurance plan.. And I figured out 2 things:

One: BCBS is bad at math when it comes to updating my tracking to my max OOP and deductible, and I absolutely cannot trust it.

Two: With Enbrel, I will have to pay as much as $500 per month until I reach my max out-of-pocket.. Which means that - if I want to keep taking this medication - I'll have 4 or 5 more bills (either 3 or 4 $500, plus one for the remainder, because again - BCBS is bad at math and can't seem to actually share what I've put towards my max OOP).

Let's deviate a bit here.

Enbrel. Fucking. Works. IT WORKS!

Yesterday morning I was dancing in my chair and snapping my fingers (to The Spinner's Rubberband Man, FYI). I sleep through the night most nights without constantly waking up in pain. My joints are still somewhat stiff, and I'm still dealing with some joint pain, but it is noticeably less.

Hell, this afternoon I was walking pain-free in the joints (nerve pain is another thing entirely, though - fuck CMT and whatever else is going on with me).

That joy is bittersweet, though, because I know: It won't last.

I have one last dose left of Enbrel, and I won't be refilling.

Paying $2000-$2500 USD annually just is not feasible. I could probably make it work (with some significant cuts in multiple areas of my life), but I have to look at it this way: Will I recoup that significant of an expense by being in less pain?

The answer, unfortunately, is.. No.

I'll never get back to being a busker or performing musician thanks to the CMT, which would be the one potential way to cover the costs of the treatment.

Now, some of you will say this: "Will! There are foundations and stuff that can help with the rest of the costs!"

That's what my doc said, so I checked them out.. And, as it turns out, I make just a bit too much money to qualify for any assistance (especially with my existing side-hustles).

We'll see if there are any other biologics with more generous payment assistance programs, but I'm not getting my hopes up there.. And either way, I'll be off the Enbrel here soon, and will be back to feeling the full weight of my broken body shortly.

I've been down that road before; Titrating off Gabapentin sucked hard, and it took a while afterwards to get back to my old familiar pain back then.

What makes it worse, though, is fucking Accredo.

For one: The fact that they refuse to check with me that I'm ready and willing to cover what is left on the bill before shipping the medication out is fucked up, and I imagine some folks have been fucked way harder than me in that regard.

Second, they are an absolute nuisance trying to get me to refill my prescription.

My local pharmacy sends me a simple text asking me if I want to refill, and I can text back with an affirmative or negative easily.

Accredo calls and texts incessantly, and it's always mid work day.. But the actually galling part is this: The initial contact is automated, but if I refuse to refill the prescription?

I have to fucking hold for a real human.

Here's another fun thing: If I want to refill? I also have to hold for a real human.

Why in the fucking fuck are you robo-harassing me then?!?

I said no. I don't give a fuck what you have to say, unless you're just going to eat the rest of my bill.

I'd almost understand them calling about my bill not being paid yet (yes, I will fucking pay it, of course), but no.. They just want me to refill my goddamned prescription that I don't want to refill, and I have told them this.

I'm not the only person with complaints regarding Accredo, either.

So, Accredo, if Google's clanker-farm crawls this article and feeds it via AI summary to whatever executive is googling the business, hear me out:

I don't want to fucking refill my Enbrel!

This post, like others that will follow it, is a continuation of my Gambling On Life series.