What are my options?
There are different biologics that could be offered to you to treat your inflammatory arthritis. One could be more appropriate for you or your type of arthritis. Make sure you discuss with your doctor the pros and cons of the different treatments available. You might want to consider:
- how the drug is given (by mouth, by injection, or by infusion)
- potential side effects or drug interactions
- the cost of the drug and your coverage
- how often you will have to take the drug
How is the drug given?
Generally, biologics need to be either injected or given by infusion (intravenous or IV). You can inject the biologic yourself, but infusions must be done in a clinic, a process that may take several hours to complete. If you will be injecting the drug yourself, you may be able to choose either a pre-filled syringe or an autoinjector pen.
An autoinjector injects without the need for you to push on the syringe plunger. Each dosage form may be slightly different. For example, the size, shape, color, and injecting mechanism can vary. You can talk with your doctor or pharmacist to decide what option is best for you. If you are getting an infusion, you may have a choice of what infusion clinic to go to. Talk to your doctor about what infusion clinics can infuse your medication, where they are located, and what other services they might include. The patient support program associated with the medication you have been prescribed can also help in identifying convenient locations for administering your treatment.
Will biologics work for me?
As with all treatments, people can react differently to the same medication. Some people find that biologics act very quickly (within days) to reduce their symptoms while others find that it takes longer (weeks or even months). Some people find that biologics help to reduce their symptoms while others find that they become nearly symptom-free. For others, biologics may not work at all.
When on biologics, you should reach out to your doctor:
- if you have a fever;
- if you have an infection;
- if you need to take an antibiotic;
- if you are considering surgery; or
- if you want to get pregnant.
How much do they cost?
Biologics are expensive drugs—whether you are paying for them yourself, or through a provincial or private drug plan. Each originator biologic and biosimilar product has an associated patient support program which helps patients obtain any drug coverage available to them to help cover the cost of the biologic. Your pharmacist can also help you understand what drug coverage is available to you.
Biosimilars are usually less expensive than the originator biologic. This is in part because it is less expensive for a pharmaceutical manufacturer to create a copy of an effective drug than to develop an entirely new drug. These reduced costs can help more patients gain access to these life-changing therapies and can allow government to allocate cost-savings towards funding other products and programs that will improve the health of Canadians.
What about fighting infections?
Biologics are designed to calm the immune system because autoimmune diseases are caused by the body’s immune system attacking its own healthy tissues. Biologics help prevent your immune system from attacking healthy tissues, but they can also make it harder for your body to attack foreign bacteria and viruses that cause infection. Therefore, when you are taking a biologic, it can be harder for your body to fight infections. You will need to be very careful to prevent infections when you are on a biologic. Wash your hands frequently and try to avoid contact with sick people who may have active infections. Also, before you start taking a biologic, make sure that your vaccinations are up to date and that you have seen your dentist to be sure you have no cavities or gum disease. It is best to get your necessary vaccinations before you start a biologic medication. Your physician or pharmacist can help you identify which vaccinations are right for you.
If you have to take antibiotics for an infection, tell your doctor so that they can assess whether or not to continue your biologic at the same time. In some cases, your doctor may advise you to temporarily stop taking your biologic until the infection is resolved. Your doctor will let you know when to resume your biologic treatment.