Arthritis

My wife and I are awaiting her skills assessment results for our visa to be lodged. I have psoriatic arthritis and take Humeria has anyone got any info reference the above.

Regards

Simcar:policeman:

Hi,

I too am on Humira and looking to move to Perth, WA with my job. I wanted to know if it costs anything to continue my perscription in oz and if so what will the cost be. I understand its expensive to the NHS here. It is to treat my Ankylosing Spondylitis.

Hi Stephane,

I also take Humira for Ankylosing Spondylitis and looking to move to Australia on a PR Visa 190. However, after doing a little research i noticed that if your drugs cost greather than $35,000 as of 1st July 2013, then you are likely to fail the medical. You can however, go on a temporary sponsored visa from an employer and sign a health waiver. What i would like to know however, (before my State sponsorship visa application timeframe runs out) is, if i chose not to take Humira for the foreseeable future, and manage without (have done previously for a period of a yr for certain reasons as directed by my consultant with minimal effect to my health), would this allow me to pass the medical. I undertstand that it is the medication and not the condition which would cause me to fail the medical. My specialist consultant for my condition has ben very supportive and will write a letter should i need any back up. Hopefully the skills i possess will outweight the negatives of putting up with me in australia. Fingers crossed. Has anyone else had any similar scenarios with Ankylosing Spondylitis or Humira or Enbrel or any other Anti TNF drugs?

Hi Stephane,

 

I also take Humira for Ankylosing Spondylitis and looking to move to Australia on a PR Visa 190. However, after doing a little research i noticed that if your drugs cost greather than $35,000 as of 1st July 2013, then you are likely to fail the medical. You can however, go on a temporary sponsored visa from an employer and sign a health waiver. What i would like to know however, (before my State sponsorship visa application timeframe runs out) is, if i chose not to take Humira for the foreseeable future, and manage without (have done previously for a period of a yr for certain reasons as directed by my consultant with minimal effect to my health), would this allow me to pass the medical. I undertstand that it is the medication and not the condition which would cause me to fail the medical. My specialist consultant for my condition has ben very supportive and will write a letter should i need any back up. Hopefully the skills i possess will outweight the negatives of putting up with me in australia. Fingers crossed. Has anyone else had any similar scenarios with Ankylosing Spondylitis or Humira or Enbrel or any other Anti TNF drugs?

Hi

I to have psoriatic arthritis and had my medical today, I'm on methotrexate injections, I gave the doctor a letter from my specialist which was dated August 2012 stating my condition which is good, but he asked when I saw my specialist last which wad February 2013 so he phoned the hospital whilst I was with him and asked for a more up to date letter. When i last visited my specialist i told him i was suffering from stiffness in my lower back in the morning so his last prognosis was i were showing early signs of Ankylosing Spondylitis and was being refered in march for a scan on my shoulder which was to do with an old mountain bike injury. The doctor didn't seem to happy with this due to still having an outstanding referral at the Time of medical but said there wasn't much he could do about that, overall he was happy with me and said my condition seems very well controlled but said I will have to see what the MOC decide as its them who make the decision, he also commented on my weight I'm 5ft 10 and weigh 85 kg but said I need to keep up the weight loss due to my condition and the impact on my joints. Overall he seemed quite happy but it's all down to the MOC so fingers crossed :mad:

Looks as though this is a special drug in Aus and not on the Pharmaceutical Benefits List, has to be approved by the hospital etc. http://www.medicareaustralia.gov.au/provider/pbs/drugs2/rheumatoid.jsp

These drugs are very expensive usually. My oh is on a drug that was financed by the hospital, hence he had to go to that specific hospital clinic to get it. My friend was also on a drug that cost her $200.00 a month. Its not cheap for medicines in Aus even on prescription.

I've had to go back onto oral Methotrexate as the subcutaneous injection isn't available on the PBS.

I was diagnosed with RA after moving to WA, I am currently on oral Methotrexate, Plaquinal and ENDEP. Biologics are not the first choice treatment here due to the cost - you have to prove other combinations don't work for you before they can be prescribed (unless you pay privately which is arounf $30k per annum). Essentially 6 months on a DMARD, 6 months on a combinations of DMARDS and then biologics can be prescribed under PBS - the rules are complex though but it seems to me Humira CAN be prescribed for psoriatic arthriris

http://www.medicareaustralia.gov.au/provider/pbs/drugs2/files/9156-1204-guide-to-prescribing-biological-agents.pdf

http://www.medicareaustralia.gov.au/provider/pbs/drugs2/rheumatoid.jsp

Providing you are eligible for medicare the maximum cost per item is $36.10 and no more than $1390.60 per annum. If your arthritis is severe you may qualify for a disability allowance or mobility allowance (if you are working) and then get a healthcare card which significantly reduces these costs - each prescription costs $5.90.

http://www.medicareaustralia.gov.au/provider/pbs/pharmacists/safety-net.jsp

Private health care will cover mecine not on the PBS but obviuosly subject to covering pre-existing conditions (usually a year eligibility and subject to excesses and maximum benefits) - if you have private health cover in the UK you may be able to transfer it here without qualifying periods.

The good news is you can continue your treatment here (though maybe not initially) but the bad news is it will cost medicare a significant amount per annum and on that basis you may not be granted a visa.

The DMARDS are cheaper so being on something like Methotrexate is not likely to prove a problem - ultimately immigration way up the benefit of you being in the country to the lifetime costs of caring for you and if the benefits outweigh the costs you will get a visa - harsh but an economic reality.

I am just relieved my diagnosis came after PR - we moved here on a 457 and if the diagnosis had come sooner we may have been sent back. There was a sad story doing the rounds of a Dr. and his family here on a 457 visa being refused PR because the wife had breast cancer. There was a public outcry and an appeal but i am not sure of the outcome.

I was diagnosed with RA after moving to WA, I am currently on oral Methotrexate, Plaquinal and ENDEP. Biologics are not the first choice treatment here due to the cost - you have to prove other combinations don't work for you before they can be prescribed (unless you pay privately which is arounf $30k per annum). Essentially 6 months on a DMARD, 6 months on a combinations of DMARDS and then biologics can be prescribed under PBS - the rules are complex though but it seems to me Humira CAN be prescribed for psoriatic arthriris

 

http://www.medicareaustralia.gov.au/provider/pbs/drugs2/files/9156-1204-guide-to-prescribing-biological-agents.pdf

http://www.medicareaustralia.gov.au/provider/pbs/drugs2/rheumatoid.jsp

 

Providing you are eligible for medicare the maximum cost per item is $36.10 and no more than $1390.60 per annum. If your arthritis is severe you may qualify for a disability allowance or mobility allowance (if you are working) and then get a healthcare card which significantly reduces these costs - each prescription costs $5.90.

 

http://www.medicareaustralia.gov.au/provider/pbs/pharmacists/safety-net.jsp

 

Private health care will cover mecine not on the PBS but obviuosly subject to covering pre-existing conditions (usually a year eligibility and subject to excesses and maximum benefits) - if you have private health cover in the UK you may be able to transfer it here without qualifying periods.

 

The good news is you can continue your treatment here (though maybe not initially) but the bad news is it will cost medicare a significant amount per annum and on that basis you may not be granted a visa.

 

The DMARDS are cheaper so being on something like Methotrexate is not likely to prove a problem - ultimately immigration way up the benefit of you being in the country to the lifetime costs of caring for you and if the benefits outweigh the costs you will get a visa - harsh but an economic reality.

 

I am just relieved my diagnosis came after PR - we moved here on a 457 and if the diagnosis had come sooner we may have been sent back. There was a sad story doing the rounds of a Dr. and his family here on a 457 visa being refused PR because the wife had breast cancer. There was a public outcry and an appeal but i am not sure of the outcome.

Thanks for the replies,fingers crossed I get a positive out come :biggrin:

Don't know anything about the visa side of it.

When you get to Aus, go straight to your Dr to start the process of getting prescribed - this took us 6 months despite having evidence from UK aobut condition and the only drugs which controlled PA. Aus Specialist had contact with UK specialist but it still took ages. Enbrel here costs $34.70 for 4 weeks on PBS. Acutal cost to Medical is just over $1700 for 4 according to printed label on the box!

Hi Stephane,

 

I also take Humira for Ankylosing Spondylitis and looking to move to Australia on a PR Visa 190. However, after doing a little research i noticed that if your drugs cost greather than $35,000 as of 1st July 2013, then you are likely to fail the medical. You can however, go on a temporary sponsored visa from an employer and sign a health waiver. What i would like to know however, (before my State sponsorship visa application timeframe runs out) is, if i chose not to take Humira for the foreseeable future, and manage without (have done previously for a period of a yr for certain reasons as directed by my consultant with minimal effect to my health), would this allow me to pass the medical. I undertstand that it is the medication and not the condition which would cause me to fail the medical. My specialist consultant for my condition has ben very supportive and will write a letter should i need any back up. Hopefully the skills i possess will outweight the negatives of putting up with me in australia. Fingers crossed. Has anyone else had any similar scenarios with Ankylosing Spondylitis or Humira or Enbrel or any other Anti TNF drugs?

Hi Rick

The information regarding the $35,000 is that per annum or over a number of years ?

Cheers

Pete

Hi Rick

 

The information regarding the $35,000 is that per annum or over a number of years ?

 

Cheers

 

Pete

Hi Pete,

I believe it is $35,000 over a 5 yr period of which i think humira is more expensive than this, however you are not currently on this right? It is your choice to go on anti tnf and if you show early syptoms, then i dont think this would cuase too much of a problem. The threshold has been increased recently i think though from $21,000 - $35,000 and their aim is to create a fairer approach. If you google Chris Bowen MP media release October 31st 2012, there is an article on it. It seem positive, and looks like they will also assess everyone on their own individual merits and what they will bring to the table for australia and if the benefits of them working in oz will outweigh the potential treatment costs.

From doing research on this topic, and speaking with various people, it seems that AS or arthritis is not particulary the stumbling block, it very much seems it is the cost of treatments and future potential treatments. I've heard a last resort to getting into oz if you fail the medical is on a company sponsorship visa and to sign a health medical waiver.

I am currently on Humira but want to ask my rhumy if i can be put on cheaper drugs for the time being. Then hopefully if it allows me to pass a medical then i would look to progress back onto anti tnf in oz. I know its a long process to obtain anti tnf in oz but i do recall having to try other treatments in the uk also before going onto it. Good advice from MamaPesa i feel to get the ball rolling as soon as you get out there and thanks for the info Jules 2409. I hope that you are managing well in WA and hope i can soon be there too.

I am

Hi Pete,

 

I believe it is $35,000 over a 5 yr period of which i think humira is more expensive than this, however you are not currently on this right? It is your choice to go on anti tnf and if you show early syptoms, then i dont think this would cuase too much of a problem. The threshold has been increased recently i think though from $21,000 - $35,000 and their aim is to create a fairer approach. If you google Chris Bowen MP media release October 31st 2012, there is an article on it. It seem positive, and looks like they will also assess everyone on their own individual merits and what they will bring to the table for australia and if the benefits of them working in oz will outweigh the potential treatment costs.

From doing research on this topic, and speaking with various people, it seems that AS or arthritis is not particulary the stumbling block, it very much seems it is the cost of treatments and future potential treatments. I've heard a last resort to getting into oz if you fail the medical is on a company sponsorship visa and to sign a health medical waiver.

I am currently on Humira but want to ask my rhumy if i can be put on cheaper drugs for the time being. Then hopefully if it allows me to pass a medical then i would look to progress back onto anti tnf in oz. I know its a long process to obtain anti tnf in oz but i do recall having to try other treatments in the uk also before going onto it. Good advice from MamaPesa i feel to get the ball rolling as soon as you get out there and thanks for the info Jules 2409. I hope that you are managing well in WA and hope i can soon be there too.

 

 

I am

Hi Rick

Thank s for the info i manage quite will just on the methotrexate and anti inflamitry tablets, i do have good and bad days but find that exercise does help and have been given a program to follow by my phisio. I got diagnosed around 3 years ago so regarding the future who knows. Ive never had time of work and submitted a letter from my manager explaining this and a letter from my specialist outlining my condition currently being stable on the meds im on. When having the medical for the visa the doctor said he had no issues with giving me a good report as his findings were all good so fingers crossed all should be ok, ill keep everyone posted as info on these subjects are hard to come by and when starting out my MA just said its a risk ill have to take :biggrin:

Pete

Hi Pete,

Thanks for sharing the info. You are right, topics on this subject are hard to come by. Can you kindly detail what the medical entails and what happens? My specialist is very supportive and understanding of the situation and would give me a good report I am sure but i want to know if me switching to a cheaper drug alternative like methotrexate, or coming off Humira will benefit me. What medication notes do they take during medical? Do they see what you have been on previously?

Many thanks

Rick

Hi Pete,

 

Thanks for sharing the info. You are right, topics on this subject are hard to come by. Can you kindly detail what the medical entails and what happens? My specialist is very supportive and understanding of the situation and would give me a good report I am sure but i want to know if me switching to a cheaper drug alternative like methotrexate, or coming off Humira will benefit me. What medication notes do they take during medical? Do they see what you have been on previously?

 

Many thanks

 

Rick[/quote

 

Hi Rick

 

The medical is quite basic really, first of its height, weight and basic eye test, as I told him I'd lost nearly a stone since last visiting my specialist he did coment on me keeping it up as weight plays a big bearing on my condition but don't think he was to concurned with me I'm only slightly over weight. Then it was down to underwear and checks you all over for skin condition make sure you can move freely by moving you from left to right touch you toes, listens to you chest checks for hernias then wee sample, blood tests & x rays regarding past conditions then I had a letter from my specialist but it was more than 6 months old so he requested a more up to date copy which he acquired by phoing the hospital whilst I was there so in my case they didn't look at any past history so if your specialist gives you an up to date letter stating your current medication then as long as that medication seems to be Woking for you then all should be ok. This was just my experiance so could be different for your self, if you can show your fit enough to do your job for the foreseeable future and the meds won't cost the earth you should be ok, fingers crossed for us both and anyone else out there trying to get past the last hurdle

 

Good Luck

 

Pete

Hi Pete,

 

Thanks for sharing the info. You are right, topics on this subject are hard to come by. Can you kindly detail what the medical entails and what happens? My specialist is very supportive and understanding of the situation and would give me a good report I am sure but i want to know if me switching to a cheaper drug alternative like methotrexate, or coming off Humira will benefit me. What medication notes do they take during medical? Do they see what you have been on previously?

 

Many thanks

 

Rick

My OPINION is that if you are on methotrexate you have a far better chance of being granted a visa purely due to the cost of biologics. The use is much more restricted here - my rheumy has said if I was in the UK that's what I'd be given.

It is not worth risking your health over though, joint erosion is permanent and a visa certainly isn't worth that.

Hi Jules,

I completely agree, I would never want to risk my health for a visa but I feel hopeful that if I can secure a visa, there is the chance that i can progress towards Humira (biologics) in Australia. I feel I have the added bonus of my specialist knowing a specialist in WA and she has offered to talk with him once/if I get out there. How long have have you been in oz and tried on other drugs before you qualify for biologics? thanks for your post.

Hi Pete,

Thanks for the info on medicals. I wish you luck with it all and hope we both manage this last hurdle as you say. Please do keep us updated and hope that we can help others reading these posts, who may be going through a similar situation .

Rick

I have been in WA for four years, I was diagnosed a year ago. I did a fabulous course at the Arthritis Foundation which not only looked at living with inflammatory arthritis but also all the Medicare and Centrelink help available. There are social groups (& I rather like th fact at 46 I am in the 'young' group ) and classes such as hydrotherapy, pilates, tai chi etc. All specifically for arthritis patients. The fees are nominal and you don't need a referral. It was on the course that I learnt about the regime of medication - one DMARD for 6 months, followed by two DMARD's for 6 months before qualifying for a biologic if the DMARD's are ineffective. The research all shows early intervention with biologics improves long term prognosis so it seems very wrong to me.

I certainly am improved on combination I'm on - Methotrexate, Plaquinal and ENDEP and have no real side effects so agreed to another three months of that combination to see if there is further improvement.

You can either see a specialist privately which is heavily subsidized by medicare anyway if you are revered by your GP - my consultations cost $110 and I think medicare pay about $60 of that (I should know as I did a claim yesterday but it was for three things coming to $290 and medicare paid $210 of it) or you can be refered for public health care which is rather like the NHS with the same kind of waiting list issues.

Worth knowing about is the chronic illness management plan which a GP can put in place and enables you to get services normally not covered by medicare eg Physio, OT, podiatrist - it is a limited number of sessions per year but it helps and RA also qualifies you for free dentistry (which is a fortune in WA) but for some reason I think psoriatic arthritis doesn't (very vague memory from the course so could be wrong!)

We are actually moving back to the UK this year so I would be interested in your experience of treatment there!

Hi Jules

When I first started getting aches and paines I went to see my GP he kept fobbing me of and even told me to buy some tablets from holland and barret even though my fingers and ankle were obviously swoled to the point where i couldnt bend them. So after 3 visits to the GP and explaining that i was struggling to do my job he eventually refered me. That was october and i got an appointment for august the following year 10 months :-( I literally hobbled through the door and after an examination he put me on some anti inflamitry tablets and to come back in 6 months with not having more than 3 swolen jont that was all he could do so on the second visit he put me on methotrexate tablets to go back in 6 months then as that didn't seem to be doing the trick he put me on the same dose but in the form of injection which does seem to have taken the swelling down but my joint are still sore so I think the damage could have already been done due to the 2 year wait, as you have already been diagnosed you may have a much smoother ride things are very tight in the NHS at the moment so make sure you play on it very much so or they may just start you back fom the bottom.

Good Luck

Pete

Hi Rick/Pete/Jules

thanks for all your messages wondering if you can point me in the right direction. My partner has been recently diagnosed with AS as well she is currently not on humira and is coping well without for the moment, she takes some meds like Meloxican, that she pays for. She is uniquely flexible and has some pain that comes and goes (she is 34), apart from that she is fit as a fiddle. My work has agreed to put me through PR (ENS) from my 457 on a transition and my partner will be on as mine as "de facto". Obvioulsy we are worried about getting her accepted through the medical (fingers are crossed).

- Would she stand a chance based on what i have said and your experiences?

- Also when do we bring it up, in the Health Character part in the Application (47ES Form) or when we have a medical?

- lastly does the desicion effect my application (as she could continue on her 457) we have been togther for 3+ years?

thanks for any help

Tchristie212

Hi Rick/Pete/Jules

 

thanks for all your messages wondering if you can point me in the right direction. My partner has been recently diagnosed with AS as well she is currently not on humira and is coping well without for the moment, she takes some meds like Meloxican, that she pays for. She is uniquely flexible and has some pain that comes and goes (she is 34), apart from that she is fit as a fiddle. My work has agreed to put me through PR (ENS) from my 457 on a transition and my partner will be on as mine as "de facto". Obvioulsy we are worried about getting her accepted through the medical (fingers are crossed).

 

- Would she stand a chance based on what i have said and your experiences?

 

- Also when do we bring it up, in the Health Character part in the Application (47ES Form) or when we have a medical?

 

- lastly does the desicion effect my application (as she could continue on her 457) we have been togther for 3+ years?

 

thanks for any help

 

Tchristie212

Hi

Ill let you know if i pass the medical:biggrin:

Pete

Hi

 

Ill let you know if i pass the medical:biggrin:

 

 

Pete

Hi Pete,

Any news back regarding your medical yet? Hope it is good news for you.

Rick

Hi Pete,

 

Thanks for sharing the info. You are right, topics on this subject are hard to come by. Can you kindly detail what the medical entails and what happens? My specialist is very supportive and understanding of the situation and would give me a good report I am sure but i want to know if me switching to a cheaper drug alternative like methotrexate, or coming off Humira will benefit me. What medication notes do they take during medical? Do they see what you have been on previously?

 

Many thanks

 

Rick[/quote

 

Hi Rick

 

The medical is quite basic really, first of its height, weight and basic eye test, as I told him I'd lost nearly a stone since last visiting my specialist he did coment on me keeping it up as weight plays a big bearing on my condition but don't think he was to concurned with me I'm only slightly over weight. Then it was down to underwear and checks you all over for skin condition make sure you can move freely by moving you from left to right touch you toes, listens to you chest checks for hernias then wee sample, blood tests & x rays regarding past conditions then I had a letter from my specialist but it was more than 6 months old so he requested a more up to date copy which he acquired by phoing the hospital whilst I was there so in my case they didn't look at any past history so if your specialist gives you an up to date letter stating your current medication then as long as that medication seems to be Woking for you then all should be ok. This was just my experiance so could be different for your self, if you can show your fit enough to do your job for the foreseeable future and the meds won't cost the earth you should be ok, fingers crossed for us both and anyone else out there trying to get past the last hurdle

 

Good Luck

 

Pete

Hi Pete,

When taking the medical. Did they specifically ask for a letter from your specialist or were you being pro-active? Trying to get hold of my specialist is like trying to speak to the queen.

Thanks

Rick

Hi Pete,

 

Any news back regarding your medical yet? Hope it is good news for you.

 

Rick

Hi Rick

No pal not heard a dicky bird 4 weeks today fingers crossed, i thought waiting for a case officer and doing the rest of it was hard but this part is worse knowing that after 12 months of hard work and a lot of cash it could all end in tears, but hey eather way i would have still wanted to give it ago just to know that we tried :biggrin:

ill keep you posted

Pete

 

Hi Pete,

 

When taking the medical. Did they specifically ask for a letter from your specialist or were you being pro-active? Trying to get hold of my specialist is like trying to speak to the queen.

 

Thanks

 

Rick

Hi Rick

My MA told me to ask for a letter from my specialist and his receptionist was a little reluctant to pass the message on and said he is a very buisy person and its is at his own descression, but he did it and when i went back in february i thanked him for doing it. When i went for medicals the letter was more than 6 months old so he phoned the specialists receptionist and asked for a more upto date prognosis (he sends a letter to my GP after each visit) which they emailed while i was having the medicals done. I would go as prepared as possible to save you time in the long run.:biggrin:

Pete

Hi Rick

 

No pal not heard a dicky bird 4 weeks today fingers crossed, i thought waiting for a case officer and doing the rest of it was hard but this part is worse knowing that after 12 months of hard work and a lot of cash it could all end in tears, but hey eather way i would have still wanted to give it ago just to know that we tried :biggrin:

 

 

ill keep you posted

 

Pete

Hi Pete,

Sorry to hear that you have not heard anything yet. It must be such a chew to wait after each hurdle. I have just started my VISA application and only a week into it so i presume i have it all to come. My specialist has written a brief letter that i can take which sounds very positive in my management of things and not missing a day of work in the UK through AS. However, i am sure she will give me a more in depth one when it comes to it (hopefully with the same glossy pen she wrote the last one with )

I am confident you will be ok though pete. I have done so much research on this topic and it certainly cheers me up the more i read rather than the opposite. ALl you can do is give it a try. Its the only way to find out. Best of luck pete and keep us all updated on your progress.

Rick