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Taking Biologics: Dosing, Insurance Coverage, and When You Can Stop (VIDEO)

Medically reviewed by Siddharth Tambar, M.D.
Written by Ted Samson
Updated on January 2, 2024
Part of the nr-axSpA Doctor Visit Checklist series

Sticking With Medication

1........2........3........Chapter 4........5

These interactive videos let you quickly find the answer to each question. Simply click on the key moments button at the top of the video, then click the question to jump directly to the answer.

Key Moments in This Video:

  • Can you skip a dose of biologic treatment?
  • When will I stop taking biologic treatment?
  • What if insurance won’t pay for biologic treatment?

    Though there’s currently no cure for nonradiographic axial spondyloarthritis (nr-axSpA), biologics help many people achieve remission — that is, periods where they’re not experiencing symptoms like joint pain. Achieving remission requires following your doctor’s directions and sticking to your treatment regimen — and most people take biologics for years.

    If you’re finding it difficult to adhere to your treatment plan, it’s time for an open, honest conversation with your doctor. If the medication is causing you problems, your doctor can adjust your dosage or tell you about alternatives. If you’re having difficulty with insurance coverage or paying for your medication, your health care team can provide guidance, advocate for you, or point you to resources for financial assistance.

    Importantly, don’t abruptly stop taking your medication, as doing so can lead to a flare-up or relapse.

    Watch this video for some guidance on how to talk to your doctor about sticking with your treatment. From there, check out other videos in this series on topics like how to discuss general treatments for nr-axSpA, how to navigate biologic therapy and potential side effects, and what lifestyle changes you can adopt to manage your condition.

    Have more questions? See if they’re among the top three questions rheumatologist Dr. Siddharth Tambar gets about nr-axSpA.

    Talk With Others Who Understand

    On MySpondylitisTeam — the social network for people with spondylitis and their loved ones — members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

    Have you and your rheumatologist discussed difficulties with sticking to your treatment regimen? What issues have you experienced, and what advice have they had? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Read More From the nr-axSpA Doctor Visit Checklist Series

    Transcript

    [Actor Portrayal]

    00:00:05:03 - 00:00:07:06
    Patient
    Is there anything else I need to know or do?

    00:00:07:17 - 00:00:18:15
    Doctor
    For biologics to be effective, you can’t skip any doses, and you have to follow all the directions. The most important thing is that once you start that treatment, you stick to it.

    00:00:19:00 - 00:00:20:11
    Patient
    When will I stop taking it?

    00:00:20:17 - 00:00:40:11
    Doctor
    AxSpA is a chronic condition, and unfortunately there's no cure right now. Although biologics can slow progression, most people take biologics for years. The goal is to get to remission, which means you're not experiencing any symptoms of axSpA, and maintain that as long as possible.

    00:00:40:18 - 00:00:45:21
    Patient
    OK, I’ll do what it takes to get into remission. What else will I need to do?

    00:00:46:05 - 00:00:57:10
    Doctor
    We'll have regular appointments to check how well it’s working for you and monitor any side effects. If you can’t keep taking it, or if it stops working, then we’ll discuss switching treatments.

    00:00:57:18 - 00:01:02:21
    Patient
    That sounds OK. One more question, what if I have problems with my insurance paying for it?

    00:01:03:00 - 00:01:16:15
    Doctor
    We have started many people on biologics at this office and we can probably help you figure out the insurance, but if your insurance won’t pay, we may be able to recommend other resources to help you get the medication you need.

    00:01:17:06 - 00:01:23:11
    Patient
    Thank you. It’s a lot to take in, but I’m feeling better about getting started.

      Siddharth Tambar, M.D. is a rheumatologist in Chicago, Illinois. He is the owner of the clinic Chicago Arthritis and Regenerative Medicine. Learn more about him here.
      Ted Samson is a copy editor at MyHealthTeam. Learn more about him here.

      A MySpondylitisTeam Member

      I was off injections for several months (doctor told me to stop due to increasing age)but now back to square one. Pain!

      August 27
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      Clarification, Have You Talked To Your Doctor About What To Expect From Biologics? .

      November 10, 2023 by A MySpondylitisTeam Member 3 answers

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