Linda Kaser, shown in her home in Florida, switched from Xeljanz XR pills when she learned they would cost her more than $4,000 a month under Medicare Part D.Brian Tietz for STAT

As many as 40,000 chronically ill seniors are choosing to endure uncomfortable, time-consuming intravenous infusions because Medicare doesn’t sufficiently cover far more convenient, and less distressing, at-home treatments with the arthritis drug Humira.

When rheumatoid arthritis patients enroll in Medicare, switching from private insurance plans, self-administered medications such as Humira and Xeljanz become unaffordable overnight, thanks to the program’s convoluted pricing of at-home prescription drugs. To reduce patients’ out-of-pocket expenses, rheumatologists often suggest a workaround: regular, hour-plus visits to a hospital or infusion center for intravenous drug treatments. 

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While at-home treatments carry their own risks, the medication change can also cause side effects for some patients whose symptoms have been stable for years on a self-administered biologic such as Humira. 

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