Rheumatoid arthritis (RA) treatments can be expensive, and if you're living with this condition, you may be wondering how to get financial help. There are no easy answers, but with some research you can learn how to advocate for yourself and chip away at what may seem like an insurmountable challenge.

Rheumatoid Arthritis Treatments Are Costly

Even for those whose insurance covers the costs of pricey biologic drugs, RA is not cheap. For people in the Medicare Part D coverage gap or the uninsured, annual out-of-pocket costs can be severe. In 2019, annual out-of-pocket costs were $4,801 for people on Medicare Part D who took biologics, including Cimzia (certolizumab), Enbrel (etanercept), Humira (adalimumab), and Simponi (golimumab), according to a study published in April 2020 in JAMA Network Open. As biosimilars — biologic drugs similar to other biologic drugs already approved by the FDA — become available in 2023, market competition may lower the cost of drugs like Humira. Still, without insurance or discount coupons, the average retail price for a year’s worth of Humira can be over $9,000, according to GoodRx; average retail costs for Cimzia are over $7,500; Enbrel is over $11,000; and Simponi averages over $7,800.

According to a study published in October 2022 in Rheumatology and Therapy, the overall mean annual cost of RA care was significantly higher for patients with moderate disease activity ($56,536) or high disease activity ($59,217) than for those in remission or with low disease activity. Even so, mean annual care costs for those in remission were $40,072 and $48,027 for patients with low disease activity.

Options for Saving on Rheumatoid Arthritis Treatments

While the figures look intimidating, experts say there are steps you can take if you’re concerned about affording and maintaining access to your RA treatments.

Uninsured? Apply for ACA or Medicaid Coverage

Open enrollment in health insurance plans through the Affordable Care Act is November 1–January 15, though you may qualify for a special enrollment period given certain life events (if you're getting married or having a child, for instance). Depending on where you live, you may also apply through your state’s insurance marketplace. A list of these states is available at the Centers for Medicare and Medicaid Services website.

You can also explore applying for Medicaid at any point during the year. A tool at HeathCare.gov will help you determine if your income qualifies for it.

Insured? Read Your Policy’s Fine Print

When the time comes around for open enrollment, look at your insurance contract for how it treats copays. If you see something unfavorable, consider switching. “We’ve had concerns that insurance companies have hidden copay accumulator programs in the fine print when people re-sign their annual contracts,” says Steven Newmark, the director of policy for the Global Healthy Living Foundation in Upper Nyack, New York. Newmark is referring to the practice of applying manufacturer’s coupons toward the deductible. “As a result, patients are caught by surprise that they haven’t met their deductible and their budget is impacted by unanticipated payments, which could be thousands of dollars depending on the structure of their health plan. Transparency and fairness is needed to protect patients from predatory payer policies.”

Look to Your HSA or FSA for Extra Savings

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, enacted in March 2020, expanded the eligible over-the-counter medications that qualify for your tax-advantaged health savings account (HSA) or flexible spending account (FSA). This includes pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs). If you rely on Advil or Motrin (ibuprofen), Aleve (naproxen sodium), aspirin, or a wide variety other OTC meds and feminine products, you can save money over the long run. Check with your HSA or FSA administrator, or your pharmacy for more information on which products are eligible.

Find Out if Your Brand-Name Drug’s Maker Provides Financial Assistance

You may qualify for free or low-cost medication through a drug manufacturer, if your income or insurance status qualifies you. Below is a list of patient assistance programs for certain name-brand drugs to treat rheumatoid arthritis. Many will also have information about discount copay cards or coupons. As Jennifer Freeman, MD, a surgeon at Texas Regional Asthma and Allergy Center in Dallas, wrote on RheumatoidArthritis.org, your healthcare provider should be able to help you identify one for the medication you are taking, and navigate the application process.

Look to Nonprofit Foundations for Financial Help or Guidance

The following foundations have been helpful to people with rheumatoid arthritis, offering funding or advice. Some funds may have waiting lists.

Healthwell Foundation

This charity provides assistance with copays, deductibles, premiums, and out-of-pocket expenses.

CreakyJoints

The online community provides detailed information about copay assistance and financial assistance, listed by drug.

NeedyMeds

This resource provides an exhaustive database of information of financial assistance, listed by drug, as well as a drug discount card.

Good Days

Good Days provides copay assistance for people with chronic diseases.

Patient Assistance Foundation

This organization helps underinsured people with out-of-pocket expenses. The rheumatoid arthritis fund currently has a waiting list, but sign up and keep checking back.

American Autoimmune Related Diseases Association (AARDA) Resource Guide

AARDA provides a listing of financial assistance programs and information.

Look for Companies That Provide Drug Coupons or Low Prices

Some companies provide drug discount cards, compare discounts, or provide drugs directly to the consumer for savings. Among them are:

Explore Switching to a Cheaper Medication

If you have run out of options for affording your medication, go back to your healthcare provider and see if there are less-expensive options for treatment, such as generic drugs or alternative ones that cost less.

Advocate for Yourself and Your RA Care

Be persistent in exploring all these options, and enlist the support of your healthcare provider to do so. Your No. 1 priority, according to Newmark? “If you are on a medication that is working, you should self-advocate and make sure that you can continue to use that medication.”