Switching from Tysabri to Copaxone

[tinaa]

Good day

I was diagnosed with MS 10 years ago. I was on Rebif for 2.5years. I still had flare ups. Came off rebif to fall pregnant. After 4 years and 7 miscarriages landed up going surrogacy route and have a healthy 1.5year baby boy. Two years ago i changed neurologists. My MS had progressed and he decided to put me on Tysabri. I have successfully taken Tysabri for 11months and doing extremely well. My medical scheme is not paying for it. They believe i should have switched to copaxone. I am looking for evidence that switching now to copaxone could cause damage. Also switching from rebif to copaxone. If you had very bad side effects on rebif would it be likely to be similar on copaxone. I am looking for evidence to support my case to stay on tysabri. Please assist

[pennstater]

have you discussed with your neuro's office? a lot of insurance companies have tysabri as tier 2 drug, meaning you have to try others first.

since you were on rebif(tier 1) and still progressing while on it, neuro should be able to assist with case. my neuro's office did for me.

you could also try calling the tysabri support line to see if they can help with your argument.

[tinaa]

Hi Kathy

Thank you! Yes it is tier 2 but my insurance company wants me to go onto another tier 1 drug copaxone fail on that and only then they will consider escalation to higher tier such as tysabri

[TinaP303]

ugh!
I hate how the insurance companies decide that you need to "fail" with one (or one more) medicine before they'll cover the one your doctor wants for you. Don't they understand what a "failure" really means to us? Why do they think they know more than the doctors?
ugh - sorry for the rant, my ins co is doing the same to me. We're appealing that, but who knows when that'll go through.