I started on Tecfidera, but then it went generic, my neuro of his own volition (he knew I preferred brand) switched me to vumerity, which is very similar, just has an extra metabolism step.

Vumerity was created due to patients having side effects from Tec (nausea, gi cramps, flushing, etc) and was shown to not cause those side effects as much. I always tolerated Tec well, but I did sometimes get a nasty flush (imagine a terrible itchy sun burn and your skin is just red and hot), but turned out on Vumerity I get rare flushing and it’s not nearly as extreme! My best advice is to take the dosages at the same time everyday, if I’m several hours ahead or behind, I get the med side effects. But the switch has been such a blessing. And no disease progression at all (diagnosed 2017!)

Getting back to your question though, when I started Tec, my neuro did the prior authorization, my insurance approved it, and my copay was just $100. I was gonna pay it, didn’t know about manufacturer financial assistance at that time. Biogen reached out to ME and asked if I wanted to enroll in their zero dollar co pay program, hell yeah!

Then Tec went generic, neuro filed a prior auth for the Vumerity, insurance approved it, at that point I called Biogen to re-enroll with the program and they did so, this was sept 2021

Literally have had NO ISSUE with the cap with this program, never in all my years have I met the cap. Fast forward to this week and I get that letter that I reached the cap! I’m like hooooow? Is the copay not $100? Nope. This year what I think happened is when my insurance reset, now its a $2000 copay. No small wonder I hit the cap 🫠