Ankylosing Spondylitis & Step Therapy
Chronic Pain, Immune Disease
Issues and Challenges
Brianna has encountered: Copay Issues, Insurance Issues, Invisible Illness, Step-Therapy / Fail First
Growing up, I had many instances of pain that couldn’t be explained. I always brushed it off as old injuries or growing pains, as my doctors were never concerned. Once I stopped playing sports, pain seemed to happen less and that only furthered the idea that it was nothing worrisome. Fast forward to 23 years old, I started experiencing instances of fatigue, back and hip pain, low-grade fevers. I had a surgery for another condition that worsened my symptoms, but my blood work came back fine.
Luckily, due to family history, I was able to get a referral to a rheumatologist in my city. After waiting a couple months, he had suspicions of spondyloarthritis and we started our trip down the road of NSAIDs my insurance company allowed. After failing 5 of them in 3 months, I went into my worst flare yet that rendered me immobile for days and I debated hospitalization. When I went back to the rheumatologist, he found that I had Ankylosing Spondylitis and fusion had happened in multiple places in my spine.
That next week, I started my first biologic to hopefully prevent further joint degradation. I injected Humira for 10 weeks until I failed out, which started my Cimzia journey in October. I have already seen vast improvement, which gives me hope that remission from AS is possible in the near future.
My Motivation and Inspiration
Finding the Arthritis Foundation was a major turning point for me. It allowed me to connect with many others nationally and in my area who are also suffering from arthritis. I felt lost when I was diagnosed with an inflammatory disease at 23 but now I see it as an opportunity to make a difference in the disability community.
Since my AS progressed so quickly without intervention, made impossible by my insurance, Step Therapy/Fail First is a huge topic of my advocacy. I want to encourage the removal or modification of these insurance procedures, as my spine may have been preserved safely if I didn’t have to try 5 less effective medications first.