I’m going through some current struggles finding ways to obtain medication for psoriatic arthritis. In the past, I was prescribed Consentyx. My husband’s insurance is through his union, the Cleveland Bakers union, and they provided us with CIGNA health insurance however, any specialty medication is not covered under the plan. Where to go through Payer Matrix 🙄. All Payer Matrix does is essentially they Google search free programs that you can obtain, which is something you could do on your own, and then send you all the information to fill out and do all the follow up work. I had been receiving Cosentyx through Novartis foundation however in 2025 that program stopped, providing any sort of assistance to individuals who have any medical insurance, even if your medical insurance does not provide special medication coverage. Now my doctor is trying to switch me to Bimzelx and it’s the same nightmare all over again. I had to go through all the hoops of the Payer Matrix program only again to be denied because I “have insurance“. Payer matrix then advised that I go through a program where my medication will be shipped from another country. I advised the program that this is actually illegal in the United States under FDA guidelines. Since then I have received no communication back from Payer Matrix.
I’ve contacted the Cleveland Bakers union representative as well out of Ohio and get told the same response that I just need to go through the program that’s listed in my insurance. I’ve expressed to them that the program they’re providing to their union employees does nothing but hinder or prohibit an individual from receiving the care they need. I am an example of that as I’ve been without my medication now for at least six months. I even expressed to them that if I had a cancer diagnosis I’d be in the same boat without treatment again they do not care. None of them care
In the past, I’ve gone through the use of a co-pay assistance card and that’s typically used up within a couple of months because the pharmaceutical companies price these specialty medication’s at thousands upon thousands of dollars
At this point, it feels hopeless. I really don’t know what else to do. Programs like these need to be stopped immediately and I’m not sure who to turn to.