The good and the bad of economics in lupus medications… here is a new twist, or perhaps an irony. Today was the day to get a call from the drug company and hear that our household earned $600 too much last year to qualify for Genentech to pay for presecribed Rituxan infusions. Perhaps we didn’t really benefit from my husband working so much overtime, who would have imagined that? A person could go crazy thinking very long about the irony. What about insurance?
Well, yesterday was the day to learn the insurance company resoundingly told the Rheumatologist “no!” Explaining to him that the FDA classified Rituxan as an off-label treatment for lupus, so they of course would not pay. Although it is an on-label treatment for certain cancers and Rheumatoid Arthritis, lupus’ closest auto-immune relative, it is not FDA approved for lupus. But, why not?
In response, the next step was to do a little personal research and find out what the FDA and other experts and authorities had to say about my wonder drug. The evening’s research revealed some interesting information about the biologic drug that changed my lupus world so amazingly 5 years ago.
Results of clinical trials were not conclusive. Many patients with lupus nephritis, and for many participants in the phase III clinical trials, improvement was not as dramatic as mine was. There were even some very sobering reports from Genentech and the FDA about two lupus patients in clinical trials who suffered reactivated virus causing fatal brain infections. After the warnings went out about those two deaths in 2006, the medical community seemed to cool quickly toward Rituxan for treating lupus. The wonder drug was not so wonderful for everyone. So what will this mean about the options ahead?
Next steps are not very clear at the moment, but one thing is certain. Dramatic, miraculous improvement experienced after Rituxan was a personal miracle. Perhaps more than ever it is clear that the healing, and all other miracles, always truly come from God’s hand, modern medicine notwithstanding! Future miracles, of healing, of strength to cope, of endurance, fortitude and the faith to trust in God’s goodness through trials are from God’s gracious and loving hand, too!