5 Months After Approval, I Still Don’t Have Ilaris – And I’m Not Okay

I’m an expert on Still’s Disease, both as a researcher and as someone living with it since childhood.

Despite this, I’ve spent the past six months fighting to access the biologic medication that keeps my rare autoinflammatory disease in check. Short of explaining all the ways Still’s Disease is terrifying, this medication literally keeps me both stable and alive.

After six month of fighting, I still don’t have it.

My uncontrolled disease is running rampant. The excess inflammation is worsening the bulging cervical discs I have, causing immense pain on top of endless frustration.

Between a self-funded insurance plan through my spouse’s employer, the plan’s administrator Employee Benefits Service Center, delays from the pharmacy benefit manager TrueScripts, and a lack of urgency from those with the power to help, I may not receive my medication before traveling to Spain next week for the OMERACT meeting — a meeting focused on improving health outcomes for rheumatology patients.

Despite my relentless efforts to navigate the system, I’ve been met with silence, slow responses, shifting responsibility, and even apathy.

This never should’ve happened in the first place.

I was previously receiving Ilaris from the Novartis patient assistance program. They ended these programs for anyone with private insurance at the end of 2024, leaving countless patients like me without a safety net and in excruciatingly declining physical and emotional health.

If someone like me — someone who knows the disease, the system, how to advocate — has this much trouble accessing essential care, I can’t help but wonder how many others are quietly struggling or have been forced to switch back to a medication that was not effective. Despite how people view me as positively stubborn, I’ve been struggling with feeling forgotten, dismissed, and being too exhausted or in pain to handle all of this.

I don’t know what else to do anymore. The hundreds of hours I’ve spent coordinating between my provider, the PBM, the insurance plan administrators, and even my spouse’s HR representative all feel like they’ve been for nothing.

What I do know is that this isn’t right. This system must change, and it has to prioritize people’s lives over profits.

Patients deserve better. I deserve better — especially when the consequences of not having medication can be fatal.

If I die because of this ongoing lack of treatment, scatter my body parts in front of all these company’s locations.

Note: Everything I share here reflects my personal experience and views — not those of my employers, collaborators, or any organizations I am affiliated with. I’m speaking for myself, sharing a deeply real, painful, and ongoing struggle that has taken an immense toll on my health, my hope, and the joy I had for this year.

Where I’ve Been

Many of you may know that I have hypermobile Ehlers Danlos Syndrome (hEDS). For the last 6 months, I’ve been dealing with a complication of this condition, called Craniocervical instability (CCI).

May be an image of text that says 'Hyperextension Hyperflexion KGEE Sprain or strain of cervical tissues'
Image description: An image of neck hyperextension and hyperflexion, which can both lead to sprain or strain of cervical (neck) tissues. (source)

My neck, my legs, and my pain levels

In December, I wound up with what we figured was a pinched nerve. One of my healthcare providers told me this was just unprocessed trauma showing up in my body. It took me switching to a new primary care provider who also has EDS for my neck issues to be taken seriously.

I had an MRI on April 1st, which showed that I now have two bulging discs in my neck.

Complicating matters is that it’s taken FIVE MONTHS for my insurance to agree to cover a medication for my Still’s Disease. I don’t have it yet, but hopefully I will this next week. They don’t want to cover this medication because it’s expensive. It’s also one of only 3 medications that treats this rare disease. I’ve already been on one of the others which stopped being as effective for me after having been on it for nearly a decade.

The extra inflammation in my body because of not having my medication is making my neck MUCH worse, to the point where the discs are booping my spinal cord. This happens occasionally, but more often than before. On top of the nerve pain this causes — which can’t be touched by any pain medication — my body is less coordinated than normal. I drop things a lot and run into things more often. The nerves in my back begin to fire all at once if I get overheated or do too much without taking a break, especially if I’m using my arms a lot. Like I said, there’s no way to attack that pain with medications.

The only way out of it is through. Sometimes that means sitting down for 5 minutes or writhing in pain for an hour.

 

Surgery isn’t really an option – yet

Because of having CCI and hEDS, surgery to fix this won’t fix the underlying issue. I also have Mast Cell Activation Syndrome, which reacted so badly with general anesthesia when I had top surgery that I nearly died.

So, surgery isn’t an option… for now. It won’t be until this gets completely unsustainable. And that’s if I could find a surgeon who would be knowledgeable about my conditions and willing to take on the risks.

I’m working with my EDS-focused physical therapist and my primary care doctor on what to do now. CCI often benefits from physical therapy. I’m not able to see my EDS PT as often as I need to, though. I also see her virtually, which is usually great. For this, though, I need to find someone to see in person. That person needs to know how to handle CCI and be willing to learn about EDS. Otherwise, I’m putting myself at risk of further injury.

 

How I’m doing

Again, I’m dealing with a lot of pain. I’ve had chronic pain since I was 5, but this is a whole different ball game. With my neck being unstable already and the lack of access to my medication, I already wasn’t going out and doing a lot. Now with the bulging discs, though, I have to be very mindful of how I support my neck. I generally have a maximum of 2 hours of sitting upright in me before I have to rest and make sure that I’m supporting my neck by using a neck brace, propping up my neck with my hands, laying down, or leaning back against a chair or couch.

This is also causing a lot of muscle spasms. I have to roll out my leg muscles every single night before I go to be on top of taking a muscle relaxer. This has eased up slightly with starting a number of vitamin supplements, but is still an ongoing issue. If I don’t do these things, my leg muscles lock up and I can’t sleep.

I’m… very tired. I’m tired of fighting insurance on getting my medication covered. This is something they said they would do back on January 30, but keep putting roadblocks in our way. I’m exhausted from having to constantly think through what I want to do and consider if it will cause my body issues. Though, I’m also just as frustrated about trying to do things and not being able to or causing myself pain in the process.

A photo of Grayson face-on. He is sitting on a couch with his left arm supporting his neck.
Image description: A photo of Grayson face-on. He is sitting on a couch with his left arm supporting his neck.

I’m very grateful to have the best two helper dogs in Hank and Dean.

Hank (left) and Dean (right) look out the front window of our house while on the couch. They are black-and-white smaller sized mixed breed dogs.
Image description: Hank (left) and Dean (right) look out the front window of our house while on the couch. They are black-and-white smaller sized mixed breed dogs.

I’m also honestly feeling worried about my spouse. This is a lot of stuff all at once. The balance between being a partner and a caregiver is a hard one to deal with. It’s overwhelming for me, absolutely. I don’t have the added helplessness of not being able to do anything about it.

 

Moving forward

We’re heading to Spain in a few weeks. I’ll be attending the 2025 OMERACT conference.

I’m honestly not sure how traveling will go, let alone attending sessions.

Thankfully, I’ll be among friends and world-renowned rheumatologists. It’s probably one of the best places to be with how my body is right now.

If I know you in real life, don’t stop inviting me to things. I can’t guarantee I’ll be able to attend anything, really. But, I still appreciate being included.

If I don’t know you in real life? IDK. Send happy thoughts my way, maybe?