u/No-Confusion-4059

Before I was diagnosed, I had a couple rounds of shots in my hand which helped quite a bit. (Decreased swelling, stiffness and pain, increased function. My hand felt almost totally normal.)

Since I’ve had a diagnosis and have been seeing a rheumatologist, no mention has been made of getting shots anymore.

Several drugs haven’t worked out yet (Otezla, leflunomide, adalimumab), my hand is much worse again, my foot is getting bad (and my main exercise is walking 3miles/day), my rheumatologist has me on prednisone now for a long time while some third party (a “specialty pharmacy” his office seems to contract with, but not the specialty pharmacy approved by my insurance?? I really don’t understand this) ISN’T getting me approval for the next med we decided to try (Rinvoq) — when all that needs to happen is for the office to give the prescription to my actual approved pharmacy and I’d have it in a day or two because (lucky, I know) I have excellent insurance which approves things quickly — but for whatever reason, they can’t/won’t do that! They’re giving my prescription to some random “specialty pharmacy” that is less than two years old and doesn’t even have a webpage — which seems to do nothing week after week — and I’m getting more frustrated, more in pain, and less functional.

Editing to clarify: I’ve been on a couple of prednisone tapers which work really well at first, then when I’m off, symptoms come back. Currently instead of ending the last steroid taper, my rheum told me to keep taking 5 mg (daily) for several weeks now while we wait on that third party to get approval from my insurance, and during this extended 5 mg/day (which I’m not thrilled about, since all I hear is how bad it is for you to take steroids) it’s gradually getting worse.

So do people with PsA get shots, or is that just something they do for people who are undiagnosed when they don’t know what your problem is? If anyone is familiar with this, I’d like to hear about your experiences!

And if anyone has insight into the “specialty pharmacy” issue — or how to navigate that — I’m interested in that too!

UPDATES Friday morning:

I called my (insurance-covered) specialty pharmacy and asked if they could request the prescription from the pharmacy that received it on April 3. Sure they said, they can, but it will take at least 5-7 business days. They said it would be much faster if my doctor just called them and asked for the prescription directly. (Yes I know - but that’s the problem - trying to get the doctor to do it.)

Then I called the rheumatologist’s office and talked to his assistant. She said they got my message from yesterday and that she was sorry no one replied. She said she would “look into” whether they could call my pharmacy because this other pharmacy “is the one who gets our authorizations for us.” I said the problem is that pharmacy won’t be able to GET an authorization because that pharmacy is not covered by my insurance.

I was super polite, and I remain open to the possibility that what they’re doing represents a rational way to get me my medication, and that I’m just a dumb-a** patient who doesn’t understand how they do things.

But literally. They just need to call my pharmacy, and yet they won’t????

The irony is that my insurance is good, my specialty pharmacy is good. Both are VERY fast — but only if someone lets them know I need a medication!!!! I mean … not rocket science.

TL;DR I’m physically miserable and the doctor’s office seems unsure whether they can take the bold step of calling my pharmacy to order the med.

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Long story short, this morning I discovered the reason that nothing is happening with the prescription my rheumatologist wrote on April 3, is that it was sent to a specialty pharmacy not covered by my insurance (my insurance requires using one of two specialty pharmacies).

I messaged the doctor’s office first thing this morning, telling them of the mistake and asking if they can please fix it. No reply.

I really want this medication. My symptoms are getting worse every day. If this were a regular medication and it went to CVS and I wanted it to go to a Walgreens, there’s a procedure to do it.

Does anyone have the experience of redirecting a prescription from one specialty pharmacy to another?