Question 1

How can I lower the cost of my methotrexate

Accepted Answer

You can lower cost of your methotrexate using one of the 4 following drug savings programs: Rx Advantage Card for methotrexate, Canadian Prescription Savings for methotrexate, methotrexate Drug Coupons, methotrexate Patient Assistance Programs

Question 2

What dosages is methotrexate available in?

Accepted Answer

methotrexate is available as a 2.5 mg oral tablet.

Question 3

What is methotrexate used for?

Accepted Answer

methotrexate is an antimetabolite that is used to treat:  Acute lymphoblastic leukemia (ALL) in adults and children; given with other chemotherapy Cutaneous T-cell lymphoma in adults; given by itself or with other chemotherapy Advanced non-Hodgkin lymphoma in adults; given with other chemotherapy Rheumatoid arthritis (RA) in adults Polyarticular juvenile idiopathic arthritis (pJIA) in children Severe psoriasis in adults

Question 4

How does methotrexate work?

Accepted Answer

methotrexate is an antimetabolite medication that treats many types of cancers and non-cancer conditions (like arthritis and psoriasis). For cancer: TREXALL works by blocking dihydrofolate reductase, a protein in your body that’s important for making DNA in cells and for cell growth. Since cancer cells grow much more quickly than healthy cells, the medication helps slow down cancer growth so the cancer can’t spread as well.

For non-cancer conditions: We don’t know exactly how TREXALL works to treat non-cancer conditions such as rheumatoid arthritis and psoriasis. But research suggests that, at lower doses, it blocks the immune system from becoming too active. For psoriasis, the medication might also help slow down the growth of skin cells.

Question 5

How do I take methotrexate?

Accepted Answer

The dose of methotrexate varies depending on what condition you’re taking the medication for. Sometimes, the dose depends on your body size or body surface area (BSA) in m2 units. It is typically taken by mouth up to 4 times a week.

Question 6

Is it safe for me to take methotrexate?

Accepted Answer

methotrexate is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if you are pregnant or breastfeeding, have alcoholic liver disease, bone marrow hypoplasia, leukopenia, thrombocytopenia or significant anemia.

Question 7

methotrexate Common Side Effects

Accepted Answer

Common side effects of methotrexate:  Mouth sores Nausea or vomiting Diarrhea Stomach upset Dizziness Tiredness Chills Fever Infection Higher liver enzyme levels in the blood Low white blood cells Low platelet levels

Question 8

methotrexate Serious Side Effects

Accepted Answer

Serious side effects are rare with methotrexate. Contact your healthcare provider immediately if you experience any of the following.  Serious infections (from having low white blood cell counts): temperature of 100.4 degrees Fahrenheit, with or without other symptoms, such as chills, cough, muscle aches, very fast heartbeat, confusion Low platelets: blood in urine or stool, nosebleeds, unexplained bruising or bleeding, bruising or bleeding that doesn’t go away Serious lung problems: sudden cough, fever, difficulty breathing Serious liver problems: nausea, vomiting, tiredness, stomach pain or swelling, pale-colored stool, dark-colored urine, yellowing of the whites of the eyes or skin Serious nervous system problems: headache, confusion, vision changes, difficulty talking, difficulty moving one side of the body, seizure, coma Serious skin reactions: painful blisters, skin wounds, peeling skin, fever, sore throat, body aches Allergic reaction: rash, difficulty breathing, swelling of the mouth or around the eyes

Question 9

Effects of other drugs, drug classes and over-the-counter products on methotrexate

Accepted Answer

The following medications may interact with methotrexate:  Concomitant administration of some NSAIDs with high dose methotrexate therapy has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and gastrointestinal toxicity methotrexate is partially bound to serum albumin, and toxicity may be increased because of displacement by certain drugs, such as salicylates, phenylbutazone phenytoin, and sulfonamides. Renal tubular transport is also diminished by probenecid; use of methotrexate with this drug should be carefully monitored Oral antibiotics such as tetracycline, chloramphenicol, and nonabsorbable broad spectrum antibiotics, may decrease intestinal absorption of methotrexate or interfere with the enterohepatic circulation by inhibiting bowel flora and suppressing metabolism of the drug by bacteria Penicillins may reduce the renal clearance of methotrexate; increased serum concentrations of methotrexate with concomitant hematologic and gastrointestinal toxicity have been observed with methotrexate. Use of methotrexate with penicillins should be carefully monitored

Question 10

Who makes methotrexate?

Accepted Answer

Various FDA-approved generic manufacturers

Question 11

Is methotrexate safe in pregnancy?

Accepted Answer

methotrexate can cause embryo-fetal toxicity, including fetal death. For non-neoplastic diseases, methotrexate is contraindicated in pregnancy. For neoplastic diseases, advise patients of reproductive potential of the potential risk to a fetus and to use effective contraception.

Question 12

What is the brand name for methotrexate?

Accepted Answer

RHEUMATREXTREXALL

Question 13

How can NowPatient help me to lower the cost of my methotrexate prescription?

Accepted Answer

After you create a FREE account with NowPatient, you will have access to 4 programs that can help lower the cost of your methotrexate prescription

Applicability to each program will be dependent on your insurance status.

Question 14

How do the NowPatient methotrexate savings programs work?

Accepted Answer

After you have created your FREE account with NowPatient, you can access the various programs from your account dashboard. Each program has clear instructions on how to check your eligibility. You can see how the process works by clicking on the feature link below and seeing the ‘How it works’ steps.

Drug Coupon and Patient Assistance Programs require an eligibility quiz to be completed.

Question 15

Are the NowPatient methotrexate savings programs suitable for everyone, regardless of insurance status?

Accepted Answer

No. Each program has its own eligibility and applicability requirements. The table below shows if a program is available to you, based on your insurance status.

	Rx Advantage Card* for methotrexate	Canadian Prescription Savings* for methotrexate	methotrexate Drug Coupon*	methotrexate Patient Assistance Program*
Insured (federal, state or government)	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured (Commercial or Private)	Available	Available	Available If Offered by Pharmaceutical Company	Available If Offered by Pharmaceutical Company
Uninsured	Available	Available	Not Available	Available If Offered by Pharmaceutical Company
Insured but without pharmacy benefit or drug coverage	Available	Available	Not Available	Available If Offered by Pharmaceutical Company

*This is not insurance.

Question 16

Are the NowPatient drug savings programs suitable for brand and generic versions of methotrexate?

Accepted Answer

No. Each program has applicability requirements. Please see below

	Rx Advantage Card* for methotrexate	Canadian Prescription Savings* for methotrexate	methotrexate Drug Coupon*	methotrexate Patient Assistance Program*
Brand	Yes	Yes	Yes, If Offered by Pharmaceutical Company	Yes, If Offered by Pharmaceutical Company
Generic	Yes	Yes	No	No

*This is not insurance.

Question 17

If you have Medicare Part D or Medicare Advantage and none of the methotrexate savings options are applicable or affordable for me, what can you do?

Accepted Answer

If you are insured with Medicare and the methotrexate drug savings options are not applicable to you and still remain unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and after you have selected your state, it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

People who qualify for both Medicare and Medicaid are called ‘dual eligibles’.

If you are denied Medicaid for methotrexate, and you are still unable to afford your copay or co-insurance element (for example if you are in the coverage gap or Donut Hole) then you may be eligible for a federal support program like Low Income Subsidy. To be eligible for Low Income Subsidy, you need to be a resident in one of the 50 States or the District of Columbia. You can check eligibility online at SSA Medicare D Extra Help. You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).

Question 18

I am uninsured or underinsured and none of the methotrexate prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If you are uninsured or underinsured (for example, methotrexate is not covered by your plan) and the drug savings options are not applicable or still unaffordable, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. State Medicaid programs may cover the full cost of your medication.

If you are denied and all else fails, and if you have been prescribed methotrexate for an FDA-approved indication, you can call the pharmaceutical company to see if they have any other assistance programs.

Question 19

I am commercially or privately insured and none of the methotrexate prescription saving options are applicable or affordable for me, what can I do?

Accepted Answer

If your medication is not covered by your plan, you can appeal your insurance company’s decision. Sometimes, a formal appeal can result in the drug being covered if it is deemed medically necessary.

If you cannot afford your copay contribution, then you can check Medicaid eligibility in your state by following the instructions at HealthCare.gov.

However, being privately insured might complicate your eligibility for Medicaid, as having private insurance may be considered in the financial eligibility assessment.

The government site is easy to use and you can select your state and it will navigate you to the appropriate contact point to make the application. If you qualify, state Medicaid may cover the full cost of your medication.

Question 20

If I have federal, state or commercial insurance and none of the methotrexate prescription saving options are applicable or affordable for me, are there any other support organisations that can help me with my co-insurance or copay contributions?

Accepted Answer

If you have already tried Medicaid and received a denial letter or if you are insured with Medicare and have been denied Low-Income Subsidy, then you can try one of the following organizational support programs:

1. Patient Access Network Foundation (PAN) assistance for methotrexate

If you are having trouble paying for your methotrexate medication due to unaffordable copays or deductibles, the Patient Access Network Foundation (PAN), may be able to assist you. To qualify for PAN assistance for methotrexate you will need to meet one or all of the following criteria:

Your income is below 400% of the federal poverty level
methotrexate is prescribed for an approved FDA indication
You live in and receive treatment in the United States or U.S. territories, even if you do not have U.S. citizenship
You have Medicare insurance coverage that covers methotrexate
If methotrexate is listed on PAN’s list of covered medications

You can check the Patient Access Network Foundation Website for more information.

2. HealthWell Foundation Copay Program for methotrexate

If you are having trouble paying for your methotrexate medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for methotrexate you will need to meet the following criteria:

You live in and are being treated in the United States
You are insured and your plan covers methotrexate
If methotrexate is listed on the HealthWell Foundation’s list of covered medications

You can check the HealthWell Foundation Website for more information.

3. Patient Advocate Foundation Co-Pay Relief Program for methotrexate

Patient Advocate Foundation’s Co-Pay Relief program exists to help reduce the financial distress you or your family may face when paying for your methotrexate treatment. If you qualify and can demonstrate the need, the foundation will provide you with direct payment covering co-pays, co-insurance, and deductibles. To qualify for assistance for methotrexate you will need to meet the following criteria:

You must be currently insured and have coverage for methotrexate
You must have a confirmed diagnosis and treatment plan
You must reside and receive treatment in the United States
Your Income must fall at or below 300% or 400% of the Federal Poverty Guideline (FPG) with consideration for the Cost of Living Index (COLI) and number in the household
Applications can also be completed by contacting the program sponsor, toll-free at 866-512-3861.

You can check the Patient Advocate Foundation Website for more information.