Starting a Biologic Prescription

Q: Can I take a biologic medication at home?

Most biologics can be taken at home using auto-injectable devices or pre-filled pens. The first dose is usually given at the doctor’s office, where you will be trained on how to use it.

Starting a biologic medication may seem a bit overwhelming. But it can be a big help in managing your chronic condition.

Biologic medications are made from living cells and target specific pathways in the immune system to control inflammation and inflammatory diseases. They are given as an injection or infusion. Biologics are typically prescribed to people with chronic diseases who have hard-to-control symptoms and not had success with other treatments. They do not cure the disease, but they can help control symptoms before they can start.

Here’s what you need to know about getting started on a biologic:

Who can prescribe biologics?

First, talk with your doctor about whether taking biologics is right for you. Biologic therapy is usually added to treatment plans for people with severe or long-term conditions that have not improved with other medications. It is not prescribed for short-term or mild conditions.

You may need to see a specialist to get a biologic prescription. Different specialists may prescribe biologics depending on the condition you have. Allergists are often recommended for people with allergic conditions such as asthma and allergies.

The type of specialists that can prescribe biologics:

Asthma: treated by allergists or pulmonologists
COPD: treated mostly by pulmonologists
Food allergies: treated by allergists
Atopic dermatitis: treated by allergists or dermatologists
Chronic rhinosinusitis with nasal polyps (CRSwNP): Treated by allergists or ENT (ear, nose, and throat) specialists
Chronic Urticaria (CU): Treated by allergists or dermatologists
Eosinophilic Granulomatosis with Polyangiitis (EGPA): Treated by allergists, pulmonologists, or rheumatologists

Why can’t my family doctor prescribe a biologic?

Biologics are specialized medications that need careful selection and monitoring. Most primary care doctors will refer you to a specialist for this type of treatment. Specialists like allergists, pulmonologists or dermatologists are trained to prescribe biologics and then monitor patients who take them. When biologics are prescribed, the specialist works with the patient to adjust and monitor the dosing according to the patient’s treatment needs.

In addition, most insurance companies require a specialist to prescribe a biologic to ensure proper care.

Specialists are trained to:

Diagnose complex, chronic conditions. Specialists can determine if biologic therapies are the appropriate next step for severe or unmanageable symptoms.
Monitor treatment. Biologics require regular monitoring, such as blood tests and clinical check-ins, to ensure safety and efficacy. Specialists are also able to treat patients in the case of side effects.
Select the right biologic. With different biologics available, specialists have the expertise to choose the best treatment option for your condition.

Getting a biologic medication prescription filled

If you are getting your biologic injection or infusion at a doctor’s office or clinic, then the staff will likely handle obtaining the medication for you.

If you are taking biologic drugs at home, then you will likely need to get it from a specialty pharmacy. These pharmacies are trained to handle complex medications like biologics. They help you understand how to take your medication and work with your doctor to ensure you get the proper care. Specialty pharmacies can provide extra support to help you manage your treatment correctly.

Due to the sensitive nature of biologics, the medication must be stored in a refrigerator. Coordinate with the specialty pharmacy on the delivery and pickup times. This can ensure the biologic remains in a temperature-controlled environment before you pick it up. Bring a cooler with you and place the medication in it for the drive home.

Where can I get my biologic prescription filled online?

Many specialty pharmacies operate online. They will deliver biologics to your home. You may need to sign for deliveries, especially for medications that require special storage or temperature-controlled packaging. Plan ahead to ensure you receive your medication on time.

Some well-known specialty pharmacies include:

These pharmacies can provide patient education, support services, and communication with healthcare providers.

Before choosing an online specialty pharmacy…

Check insurance coverage. Confirm with your insurance company that it will cover the biologic and if coverage includes obtaining it from the specialty pharmacy.
Consult your doctor. Your doctor might suggest a specific specialty pharmacy based on your treatment and medication needs.
Look into financial help. Some specialty pharmacies and drug companies may offer programs to help people who can’t afford their biologic medications.

Choosing a reliable specialty pharmacy will help make sure you get the care and support you need for your treatment.

Refilling a biologic prescription

The frequency of biologic refills depends on the specific medication and treatment plan. Some biologics are taken every two weeks, while others may be taken monthly or even less often. Your doctor will create a schedule based on your needs.

Specialty pharmacies may offer automatic refill services to make sure you don’t miss a dose. Keep track of your refills and plan ahead, as biologics often require temperature-controlled shipping, which can take longer to arrive.

If you have questions about your refills or you are concerned about getting your medication on time, talk to your healthcare provider or specialty pharmacy for assistance.

Is a biosimilar available for your biologic?

Biosimilars are basically copies of the original biologic drug. They are designed to be just as safe and effective.

Biosimilars usually cost less after the original manufacturer’s exclusive rights to make the drug end. These medications go through strict testing to make sure they work the same way as the original, even though they are usually made by a different company.

If the cost of a biologic is a concern, talk to your healthcare provider about whether a biosimilar might be right for you.

Can I take a biologic medication at home?

Most biologics can be taken at home using auto-injectable devices or pre-filled pens. The first dose is usually given at the doctor’s office, where you will be trained on how to use it. The doctor will also observe you after the first dose to see if there are any potential side effects.

After that, you can take the medication yourself at home if you feel comfortable doing so. If you’re unsure, your doctor or pharmacist can help.

One biologic – reslizumab (Nucala®) – is only available as an infusion. People who want to take reslizumab at home may be able to have a healthcare professional come to their house to administer it.

What to know before starting biologics

Before starting a biologic, your doctor may ask for tests, like blood tests or a chest X-ray. These tests help make sure it’s safe for you to begin treatment. The tests might check for certain infections like tuberculosis (TB). Biologics can make it harder for your body to fight infections.

Here is what to keep in mind as you start biologic therapy:

Benefits

Biologic medication can provide significant relief by decreasing inflammation and reducing symptoms. They can slow disease progression in conditions like asthma, atopic dermatitis, and urticaria.

Side effects

Common side effects include an injection site reactions, headache and/or fatigue.

Infection risks

Biologics can increase the risk of infections. Be vigilant about any signs of illness and report them to your doctor immediately if concerned. Washing your hands often, staying away from sick people, and keeping up with vaccines are all good habits to follow.

Regular monitoring

You may need regular check-ups or tests to monitor your response to the biologic and manage any side effects.

Long-term commitment

Many biologic treatments require long-term use to maintain their benefits, so be prepared for an ongoing treatment plan.

Cost and insurance

Biologics are expensive. Before starting treatment, verify insurance coverage and explore financial assistance options. Find out if a biosimilar is available of the biologic counterpart.

Communication

Keep open lines of communication with your doctor. Speak about any concerns, side effects, or changes in your health condition.