Symptoms that arise from certain types of autoimmune diseases can be difficult to manage without appropriate medications. Your doctor may prescribe Otezla to help you control your condition and relieve certain symptoms, such as inflammation or swelling around the joints.

Conditions Treated with Otezla

Sold under the brand name Otezla, apremilast is a medication that the FDA has approved for use in the treatment of certain types of oral ulcers, psoriatic arthritis and plaque psoriasis. By blocking an enzyme that plays a pivotal role in the body’s immune response to inflammatory triggers, Otezla can be used to reduce inflammation over time.

A prescription for Otezla will typically require a person to titrate up to the recommended dose, which means they will start with smaller doses that increase over time until they reach the dosage their doctor prescribes. This typically takes place over the course of a week, but your doctor may suggest a different schedule. People who take Otezla can do so with or without food and the medication should be swallowed whole rather than being chewed, crushed or split into pieces.

Risks and Side Effects Associated with Otezla

As with any medication, the chance of discovering a previously unknown allergy to an ingredient in the medication is always possible If someone experiences difficult swallowing or breathing, rashes or any sudden onset of discomfort, they should seek medical attention immediately.

Side effects that may occur when taking Otezla can include gastrointestinal discomfort, headaches and nausea. Certain types of medications can make Otezla less effective. Discuss any existing health conditions, medications or supplements with a doctor before taking Otezla so that they can determine if Otezla is the best medication for your needs.

Medicare Coverage for Otezla

Prescription drugs that are fulfilled by a pharmacy for use in the home are typically not eligible for coverage under Medicare insurance through Part A or Part B. Medicare recipients have several options if they are interested in finding prescription coverage that pairs with their Medicare insurance.

Medicare Part D Prescription Drug Plans can be purchased as a standalone service through third-party insurers contracted by Medicare. The monthly premium, prescription copays and any deductibles are paid in addition to those associated with Part B’s Medicare coverage.

Alternatively, recipients can choose a Medicare Advantage plan that includes a Medicare Part D plan alongside its Part A and Part B services. Like standalone Part D plans, these are offered through Medicare-approved private insurers. However, in this case, the Part B premium is included as part of the Medicare Advantage plan’s overall premiums. Some Medicare Advantage plans also offer extra benefits that can lower out-of-pocket expenses related to copays and deductibles.

Low-income Medicare recipients may be eligible for Part D Extra Help through their state’s Medicaid program. Eligibility rules for this and other Medicaid-related programs are determined by each state.

Formularies, or the list of drugs included in a coverage plan, can change throughout the year whether it’s a plan administered by Medicaid, a standalone Part D plan or one associated with a Medicare Advantage Plan. Recipients should speak to plan representatives to confirm if the medication they need is included in that plan’s formulary.

Related articles:

Does Medicare Cover Joint Replacements?(Opens in a new browser tab)

Does Medicare Cover Botox for Migraines?(Opens in a new browser tab)