BIOLOGICAL MEDICATIONS

Biologic therapy is a new category of treatment that helps regulate your body’s immune response to certain diseases by targeting different types of molecules. There are a few biologic therapy drugs that can treat Asthma, Atopic Dermatitis and Nasal Polyps. Most of these drugs are given as a subcutaneous injection (shot under the skin). Your first dose will always require medical supervision with monitoring in the doctor’s office to make sure you do not have any reactions to these drugs. Depending on which drug, some will require continuous medical supervision in the doctor’s office for each injection and others can be self-administered at home. The frequency of injections varies between 2-4 weeks.

Our medical provider will determine the appropriate Biologic therapy depending on your diagnosis, safety data and criteria set by your insurance plan for coverage.

Examples of types of Biologic therapy drugs are:

  • Injectable : Omalizumab (Xolair), Mepolizumab (Nucala), Benralizumab (Fasenra), Dupilumab (Dupixent), Tezepelumab-ekko (Tezpire), Tralokinumab-ldrm (Adbry)
  • Oral : Upadacitinib (Rinvoq), Abrocitinib (Cibinqo)

The most common side effects are muscle and joint aches, fatigue, injection site reaction, headaches and sore throat. Rarely, there can be severe allergic reactions that require emergency medical treatment.

TIME CONSIDERATION:

  • Please plan to be in the office for 1-3 hours for your 1st visit.  This will include drug preparation, teaching on self-administered technique (if applicable), monitoring for any adverse reactions and education on the insurance process to continue therapy.
  • Patients who continue receiving their injections in the office will require a 30-minute period of monitoring after each dose.
  • For some specific drugs, patients will need a medical clearance from our providers to do self-administration at home.

FINANCIAL CONSIDERATION:

  • The cost of each Biologic therapy drug ranges between $2000-$5000/dose.
  • All insurance plans have strict guidelines to authorize coverage and require the trial and failure of several types of treatment.
  • The authorization process for new starts can take 2-3 months, depending on the efficiency and availability of your insurance personnel.
  • The renewal process can take 1-2 months.
  • Clinic visits every 3-6 months are required to monitor benefit from therapy, monitor for possible adverse reactions and determine the medical necessity for continuation of therapy.

Patients will be responsible for the cost of the medication if your insurance coverage has ended, regardless of the date of the authorization. Please inform our office immediately for any changes in your insurance coverage so we can re-apply for a new authorization. Please do not get your dose unless you have confirmed a valid authorization.