Humira (adalimumab) and Remicade (infliximab) are two leading biologic medications widely used to treat autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and psoriasis. These medications belong to a class of drugs known as tumor necrosis factor (TNF) inhibitors, designed to suppress the overactive immune response responsible for inflammation and tissue damage in autoimmune conditions. Although both drugs share a similar mechanism of action, they differ significantly in their mode of administration, convenience, costs, and side effect profiles.
Choosing between Humira and Remicade is a decision that depends on various factors, including a patient’s specific condition, medical history, lifestyle, and personal preferences. Humira is often praised for its convenience and ability to be self-administered at home, while Remicade’s infusion-based delivery offers immediate medical supervision, which may be essential for certain patients. However, both drugs come with potential risks and limitations, including side effects, long-term costs, and varying effectiveness across patient populations.
This article explores 10 pros and 10 cons of Humira and Remicade, providing a balanced and detailed perspective on their advantages and challenges. By delving into these factors, this analysis aims to help patients and healthcare providers make informed decisions about which medication best suits individual needs and treatment goals.
Pros Of Humira
1. Convenience Of Self-Administration
Humira’s most significant advantage is its convenience, as it is administered via a pre-filled syringe or pen that patients can inject themselves at home. This eliminates the need for frequent visits to medical facilities, making it particularly appealing to patients with busy schedules, those who live far from healthcare centers, or those who prefer privacy during treatment. The at-home administration allows patients greater control over their treatment, fostering independence and improving adherence to prescribed regimens. For patients managing chronic conditions, the ability to self-administer Humira reduces the time, effort, and expenses associated with traveling for treatment. Moreover, detailed training and support from healthcare providers ensure that most patients can confidently perform self-injections, adding to the medication’s user-friendliness. This convenience has been shown to improve patient satisfaction and overall quality of life, making Humira a preferred option for many individuals.
2. Longer Time Between Doses
One of the notable advantages of Humira is its dosing schedule, which typically requires administration every two weeks. In some cases, based on a patient’s medical condition and how well they respond to treatment, this interval can be extended to once every three weeks. This less frequent dosing makes Humira less disruptive compared to medications requiring weekly or more frequent administration. For patients managing long-term autoimmune conditions, this reduced dosing frequency not only improves treatment adherence but also enhances their overall quality of life. Patients don’t have to schedule their lives around frequent treatments, allowing for greater flexibility in travel, work, and daily activities. Additionally, the biweekly or monthly dosing schedule makes it easier to integrate Humira into routine care plans, ensuring that patients are less likely to miss doses. This convenience is particularly advantageous for individuals who might otherwise struggle with consistent treatment, such as those with hectic lifestyles or limited access to healthcare facilities.
3. Fewer Allergic Reactions
Humira is less likely to cause allergic reactions during administration compared to infusion-based treatments like Remicade. Since Humira is administered subcutaneously, it bypasses the risks associated with intravenous (IV) infusions, such as immediate hypersensitivity reactions or infusion-related side effects like chills, fever, or shortness of breath. This reduced risk is particularly beneficial for patients with a history of allergic responses or those who are apprehensive about potential reactions during treatment. Additionally, because Humira is injected at home, patients avoid the stress of needing emergency intervention for adverse reactions during infusions. Although all medications carry some risk of side effects, Humira’s delivery method inherently reduces certain risks, making it a safer option for individuals prone to allergic sensitivities. Its tolerability profile ensures that patients are more likely to stick with the treatment, leading to better long-term outcomes.
4. Wide Range Of Indications
Humira is FDA-approved for a broad spectrum of autoimmune conditions, making it one of the most versatile biologics available. It is commonly used to treat rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis, plaque psoriasis, hidradenitis suppurativa, and uveitis. This wide range of indications allows Humira to be prescribed for multiple coexisting conditions, simplifying treatment plans for patients dealing with overlapping autoimmune disorders. For example, a patient with both Crohn’s disease and ankylosing spondylitis can manage both conditions with Humira, reducing the need for multiple medications. This versatility also makes Humira a trusted option for physicians who treat diverse patient populations, as it addresses a variety of inflammatory conditions effectively. Additionally, ongoing research and expanding indications continue to solidify Humira’s position as a leading biologic treatment, ensuring its relevance and reliability in managing autoimmune diseases.
5. Availability Of Biosimilars
Humira has a range of biosimilars, such as Amjevita, which offer more affordable alternatives to the brand-name drug. Biosimilars are designed to provide the same efficacy, safety, and quality as the original medication but at a significantly reduced cost. This availability makes Humira accessible to a broader range of patients, including those with limited financial resources or inadequate insurance coverage. The introduction of biosimilars also fosters competition in the pharmaceutical market, potentially lowering costs for patients over time. Additionally, biosimilars maintain the same dosing schedules and administration methods as the original drug, ensuring that patients switching from Humira experience minimal disruptions in their treatment. For healthcare providers, the availability of biosimilars expands the range of options they can offer, allowing them to tailor treatments based on both clinical effectiveness and patient affordability.
6. Minimal Infusion-Related Risks
Humira’s subcutaneous administration eliminates the risks commonly associated with intravenous infusions, which are required for Remicade. Infusion-related reactions, such as fever, chills, low blood pressure, or allergic responses, are not a concern with Humira’s delivery method. This is particularly advantageous for patients who have previously experienced discomfort or complications during IV treatments. The absence of infusion-related risks also reduces the need for close medical monitoring during administration, enabling patients to manage their treatment independently at home. This streamlined process enhances patient comfort and reduces anxiety often associated with hospital or clinic visits for infusions. Additionally, the lack of infusion-specific risks allows Humira to be a safer option for patients who may have compromised immune systems or heightened sensitivities. The convenience and safety of self-administration provide a significant benefit for long-term users who require consistent, uninterrupted treatment.
7. High Patient Satisfaction
Humira consistently ranks high in patient satisfaction surveys due to its convenience, effectiveness, and tolerability. Many patients appreciate the autonomy of self-administering the medication at home, allowing them to maintain their routines without frequent clinic visits. Its biweekly dosing schedule further adds to its appeal, enabling patients to focus on their lives rather than constant medical appointments. The medication’s ability to provide significant relief from symptoms also contributes to its high satisfaction rates, with many patients reporting improved quality of life and better disease management. The support provided by Humira’s patient assistance programs, which include financial aid, educational resources, and injection training, enhances the overall treatment experience. By addressing both the medical and logistical challenges of managing autoimmune diseases, Humira ensures that patients feel empowered and supported throughout their treatment journey.
8. Reduced Travel And Time Commitment
For patients with chronic conditions requiring ongoing treatment, minimizing the need for frequent travel to medical facilities is a considerable advantage. Humira allows patients to self-administer injections in the comfort of their homes, significantly reducing the time and costs associated with traveling for treatment. This benefit is particularly impactful for individuals living in rural or remote areas with limited access to infusion centers. By eliminating the need for regular clinic visits, Humira helps patients reclaim valuable time that can be spent on work, family, or leisure activities. The reduced travel requirement also eases the burden on caregivers who might otherwise need to accompany patients to appointments. For those balancing busy schedules or managing multiple responsibilities, the time-saving convenience of Humira’s self-administration is a key factor in its widespread use and preference.
9. Effective Across Multiple Demographics
Humira has been proven effective across diverse patient populations, including various age groups, genders, and ethnicities. Clinical studies and real-world data consistently demonstrate its ability to provide symptom relief and improve disease outcomes across a broad demographic spectrum. This adaptability makes it a reliable treatment option for patients with differing needs and medical histories. For example, Humira is approved for pediatric use in certain conditions, such as juvenile idiopathic arthritis and Crohn’s disease, ensuring that younger patients also benefit from its efficacy. Additionally, its effectiveness in treating both mild and severe cases of autoimmune diseases further underscores its versatility. This broad applicability ensures that Humira remains a cornerstone treatment for autoimmune conditions, meeting the needs of a diverse and growing patient base.
10. Extensive Support Programs
Humira offers comprehensive patient support programs designed to address financial, educational, and logistical barriers to treatment. These programs provide financial assistance to help patients afford their medication, ensuring that cost does not become a prohibitive factor. Educational resources, including detailed guides and tutorials, empower patients with the knowledge needed to manage their condition effectively. Injection training is also provided to ensure that patients feel confident and comfortable self-administering the medication. Additionally, dedicated support lines allow patients to access guidance and assistance whenever needed. These programs enhance the overall treatment experience, reducing stress and fostering a sense of control over one’s healthcare journey. For patients facing the challenges of managing chronic conditions, such robust support systems make a significant difference in maintaining adherence and achieving positive outcomes.
Pros Of Remicade
1. Immediate Medical Supervision During Infusions
One of the primary advantages of Remicade is that it is administered intravenously in a clinical setting under direct medical supervision. This ensures that any adverse reactions, such as infusion-related allergic responses or side effects, can be identified and managed immediately. Patients with a history of severe allergies or those at risk of complications benefit from the controlled environment, as healthcare professionals are on hand to provide prompt interventions. The safety provided by direct monitoring makes Remicade an excellent choice for patients requiring close observation during treatment, particularly during the initial dosing phase. For some individuals, this added layer of supervision offers peace of mind, knowing that their treatment is being managed in a safe, medically equipped setting.
2. Potent Effectiveness For Severe Cases
Remicade is particularly effective for patients with severe or treatment-resistant autoimmune conditions. It is often recommended for individuals who have not responded adequately to other medications, including subcutaneous biologics like Humira. The intravenous delivery method ensures that the medication is absorbed directly into the bloodstream, resulting in faster and more pronounced anti-inflammatory effects. For example, patients with aggressive Crohn’s disease or severe rheumatoid arthritis often experience significant symptom relief after starting Remicade. This potency makes it a preferred option for managing complex or advanced cases, providing a critical treatment option for those who require intensive care to control their condition.
3. Longer Dosing Intervals After Initial Phase
Remicade’s dosing schedule is another advantage for patients seeking fewer treatments over time. After the initial loading phase, which involves three infusions within the first six weeks, subsequent doses are typically administered every six to eight weeks. This extended interval between treatments reduces the frequency of medical appointments, making it less burdensome for patients in the long term. While the initial phase requires more frequent visits, the subsequent spacing allows for greater flexibility and less disruption to daily life. Patients who prioritize fewer interventions often find this schedule more manageable compared to medications requiring biweekly or monthly doses.
4. Proven Long-Term Efficacy
Remicade has been extensively studied and used for decades, establishing its reputation as a reliable long-term treatment for autoimmune conditions. Clinical trials and real-world evidence consistently demonstrate its ability to maintain disease control and improve quality of life over time. Many patients on Remicade experience sustained remission of symptoms, which is particularly important for chronic conditions requiring lifelong management. Its long-term effectiveness is reassuring for both patients and healthcare providers, ensuring consistent and predictable outcomes for individuals who rely on it for disease control.
5. Rapid Onset Of Action
Due to its intravenous delivery, Remicade often works faster than subcutaneous options like Humira. By entering the bloodstream directly, the medication begins targeting inflammation almost immediately, providing quicker relief for patients experiencing acute symptoms or flare-ups. This rapid onset is particularly beneficial for conditions such as ulcerative colitis or severe psoriatic arthritis, where immediate symptom control is crucial. Patients in distress from severe pain, swelling, or gastrointestinal issues often experience noticeable improvements shortly after their first infusion, making Remicade an effective choice for managing urgent or escalating conditions.
6. Tailored Dosing Flexibility
Remicade allows for greater dosing flexibility, as healthcare providers can adjust the dosage based on a patient’s response to treatment. This personalized approach ensures that each patient receives the optimal amount of medication to control their condition effectively. For instance, patients with more severe symptoms may benefit from higher doses or shorter intervals between infusions, while those with stable disease can maintain lower doses. This adaptability is particularly useful for individuals with complex or fluctuating conditions, as it enables treatment to be fine-tuned over time to achieve the best possible outcomes.
7. Suitable For Combination Therapy
Remicade is often used in combination with other medications, such as methotrexate, to enhance its efficacy and reduce the likelihood of developing antibodies against the drug. Combination therapy is particularly beneficial for patients with severe rheumatoid arthritis or other autoimmune diseases that require aggressive treatment. By integrating Remicade with other therapies, healthcare providers can achieve better disease control while minimizing the risks associated with monotherapy. This compatibility with adjunctive treatments makes Remicade a versatile option for managing complex autoimmune conditions.
8. Established Safety Profile
As one of the first TNF inhibitors to receive FDA approval, Remicade has a well-established safety profile supported by decades of research and clinical use. Its long history in the market provides healthcare providers with a deep understanding of its potential risks and benefits, ensuring informed decision-making when prescribing the medication. Patients and physicians alike can rely on Remicade’s extensive track record, which adds a layer of confidence in its efficacy and safety for long-term use.
9. Regular Monitoring Promotes Better Outcomes
The clinical setting of Remicade infusions offers an opportunity for regular monitoring, ensuring that patients receive comprehensive care during their treatment journey. Healthcare providers can assess patients’ progress, identify potential side effects early, and adjust treatment plans as needed. This proactive approach reduces the risk of complications and enhances the effectiveness of the medication. For patients who require ongoing evaluation, such as those with fluctuating disease activity, this hands-on care ensures that their condition remains well-managed over time.
10. Comprehensive Insurance Coverage
Many insurance plans provide robust coverage for infusion-based medications like Remicade, as they are administered in clinical settings. This often makes Remicade more accessible to patients with adequate insurance, as the cost of the medication and administration is typically included in the coverage. Infusion centers also assist with billing and reimbursement processes, reducing the financial and administrative burden on patients. For individuals with limited access to financial resources, insurance coverage can make Remicade a viable and affordable treatment option.
Cons Of Humira
1. Pain And Discomfort During Self-Administration
While Humira offers the convenience of self-administration, the process can cause pain or discomfort for many users. Injecting the medication subcutaneously often leads to a stinging or burning sensation at the injection site, especially if administered too quickly. Over time, frequent injections can result in bruising, scarring, or irritation, particularly if proper site rotation is not followed. This can make the experience unpleasant for some patients, potentially leading to reduced adherence to treatment schedules. Additionally, patients with needle phobia or a low pain tolerance may find self-administration particularly challenging, even with adequate training. While strategies like cooling the injection site or slowing the injection process can help mitigate discomfort, the pain associated with self-injection remains a significant drawback for some individuals.
2. Risk Of Serious Infections
Humira, as a TNF inhibitor, suppresses the immune system to reduce inflammation, but this increases susceptibility to infections. Patients on Humira have a heightened risk of developing serious infections, such as tuberculosis (TB), invasive fungal infections, and bacterial illnesses. Individuals with latent TB or other underlying health issues are especially vulnerable, necessitating rigorous screening before starting the medication. Even with proactive monitoring, the risk of contracting infections persists, particularly in environments where exposure to pathogens is high. For patients with compromised immune systems, these risks may outweigh the benefits, making this a notable concern.
3. High Cost Without Insurance
The high cost of Humira is a major barrier for many patients, with monthly treatment expenses reaching thousands of dollars without insurance. Even for those with insurance, high deductibles, co-pays, or tiered pricing systems can make the medication financially burdensome. While manufacturer assistance programs and biosimilar alternatives provide some relief, they are not universally accessible. Long-term treatment can result in cumulative financial strain, forcing some patients to delay or discontinue therapy. This affordability challenge is particularly significant in regions with limited healthcare subsidies or for patients without robust insurance plans, emphasizing the need for broader access to cost-effective solutions.
4. Development Of Antibodies
Over time, some patients using Humira may develop antibodies against the drug, reducing its efficacy. These anti-drug antibodies can neutralize Humira’s therapeutic effects, leading to diminished symptom control and even treatment failure. The presence of these antibodies may also increase the likelihood of adverse reactions, complicating the treatment process. Patients who develop antibodies often need to switch to alternative biologics, which can involve a trial-and-error period to find an effective replacement. Combination therapies, such as using Humira alongside methotrexate, are sometimes employed to minimize this risk, but this approach can increase treatment complexity and cost.
5. Limited Effectiveness For Certain Patients
While Humira is highly effective for many, it does not work equally well for all patients. Some individuals may experience only partial symptom relief, while others may see no improvement at all. This variability can be frustrating for patients who have high expectations for treatment or who have already tried multiple therapies without success. The limited effectiveness in certain populations underscores the importance of individualized treatment plans and ongoing monitoring to determine whether Humira is the right choice for a given patient.
6. Potential For Severe Side Effects
Humira can cause a range of side effects, some of which are severe. Common issues include injection site reactions, headaches, and gastrointestinal discomfort. More serious complications include liver damage, blood disorders, and an increased risk of certain cancers, such as lymphoma. These potential side effects require regular monitoring and may necessitate discontinuation of the medication in some cases. For patients with pre-existing health conditions, the risks associated with Humira may outweigh the benefits, limiting its suitability as a treatment option.
7. Frequent Monitoring Requirements
Patients on Humira require frequent medical monitoring to ensure safety and efficacy. Regular blood tests, liver function tests, and infection screenings are necessary to detect potential complications early. This ongoing monitoring can be time-consuming and inconvenient for some individuals, particularly those with busy schedules or limited access to healthcare facilities. While these measures are essential for safe use, they add another layer of complexity to the treatment process.
8. Risk Of Allergic Reactions
Although less common, allergic reactions to Humira can occur and range from mild to severe. Symptoms may include rash, itching, swelling, or difficulty breathing. Severe allergic reactions may require immediate medical attention and discontinuation of the medication. The unpredictability of these reactions can be a source of anxiety for some patients, particularly those with a history of drug allergies.
9. Potential Impact On Fertility And Pregnancy
The safety of Humira during pregnancy and its potential effects on fertility are areas of concern for many patients. While studies suggest that Humira may be safe for use during pregnancy, its long-term impact on fertility is not fully understood. Women planning to conceive or those who are pregnant often face uncertainty regarding the risks and benefits, requiring careful consultation with their healthcare providers. This uncertainty may deter some patients from starting or continuing treatment.
10. Delayed Onset Of Action
Humira, while effective for many, does not provide immediate relief for most patients. It can take several weeks or even months to notice significant improvements in symptoms. This delayed onset can be frustrating for individuals seeking rapid relief from their condition, particularly those experiencing acute or severe symptoms. The slow response time may also lead some patients to question the medication’s effectiveness, potentially affecting adherence to the treatment plan.
Cons Of Remicade
1. Risk Of Infusion Reactions
One of the most significant disadvantages of Remicade is the risk of infusion-related reactions. These reactions occur during or shortly after the intravenous infusion and can range from mild to severe. Symptoms may include fever, chills, shortness of breath, headache, itching, or a drop in blood pressure. In some cases, patients may experience anaphylaxis, a life-threatening allergic reaction requiring immediate medical intervention. While healthcare professionals monitor patients during infusions to manage such risks, the possibility of adverse reactions can be distressing, particularly for first-time users. The need for medical supervision also adds to the overall time and cost of treatment. Even with precautions, infusion reactions remain a concern for many patients and can necessitate discontinuation of the medication in severe cases.
2. Time-Intensive Infusion Process
Remicade requires administration through intravenous infusions in a clinical setting, making it a time-consuming process. Each infusion session can last two to three hours, including preparation and post-infusion observation. For patients with demanding schedules or limited access to medical facilities, this requirement can be a significant inconvenience. The frequent appointments—especially during the initial loading phase—can disrupt work, family commitments, and other responsibilities. Additionally, travel to and from infusion centers adds to the time burden, making the treatment less appealing for those who prefer a more flexible option. Patients in rural or underserved areas may face further challenges in accessing infusion centers, compounding the logistical difficulties.
3. Higher Risk Of Antibody Development
Over time, patients on Remicade may develop antibodies against the medication, reducing its effectiveness. These anti-drug antibodies can neutralize the treatment’s impact, leading to diminished symptom control or treatment failure. Additionally, the presence of antibodies increases the likelihood of infusion-related reactions, further complicating the treatment process. To mitigate this issue, Remicade is often prescribed in combination with immunosuppressive drugs like methotrexate, which can help prevent antibody formation. However, combination therapy introduces additional risks and side effects, making the overall treatment plan more complex. The development of antibodies can necessitate switching to alternative therapies, adding another layer of uncertainty for patients.
4. Limited Convenience Compared To Humira
Unlike Humira, which can be self-administered at home, Remicade’s infusion-based delivery requires regular visits to medical facilities. This lack of flexibility can be a significant drawback for patients who value convenience and independence in their treatment regimen. The need for clinical supervision during infusions not only disrupts daily routines but also creates logistical challenges, particularly for those living in remote areas or managing transportation difficulties. For individuals who prioritize ease of use, the dependence on infusion centers makes Remicade a less attractive option compared to subcutaneous biologics.
5. Potential For Severe Side Effects
Remicade, like other TNF inhibitors, carries the risk of severe side effects. Common issues include headaches, nausea, and upper respiratory infections, but more serious complications can occur, such as liver damage, heart failure, and increased susceptibility to certain cancers like lymphoma. Patients with pre-existing health conditions, such as heart disease or chronic infections, may face heightened risks, requiring careful monitoring. The potential for severe side effects makes it essential for patients to undergo regular evaluations, adding to the overall complexity of the treatment process.
6. Costly Without Adequate Insurance
The cost of Remicade infusions is another significant disadvantage, particularly for patients without robust insurance coverage. Each infusion can cost thousands of dollars, and the cumulative expense of regular treatments can become overwhelming for long-term users. Even with insurance, high co-pays or deductibles can create financial strain. While manufacturer assistance programs and insurance reimbursements help alleviate some of the financial burden, the overall cost remains a concern for many patients, especially those requiring lifelong treatment.
7. Greater Risk Of Infections
Similar to Humira, Remicade suppresses the immune system to control inflammation, increasing the risk of infections. Patients on Remicade are more susceptible to serious infections such as tuberculosis (TB), bacterial sepsis, and fungal infections. Regular screening for latent TB and other potential infections is required before starting treatment, but the risk persists throughout the course of therapy. For patients with pre-existing health conditions or those living in high-risk environments, this heightened vulnerability to infections may outweigh the benefits of the medication. Careful monitoring and preventive measures are essential to mitigate these risks.
8. Inconvenience For Travel
Patients on Remicade face significant challenges when traveling, as the treatment requires regular infusions administered in clinical settings. Unlike self-administered medications like Humira, which can be taken along during trips, Remicade necessitates planning appointments around travel schedules. For frequent travelers or individuals with unpredictable routines, this restriction can be a considerable inconvenience. Additionally, accessing infusion centers in unfamiliar locations or coordinating care with out-of-network providers can complicate travel plans further, limiting flexibility and spontaneity.
9. Dependence On Healthcare Facilities
The reliance on healthcare facilities for infusions makes Remicade less accessible for patients in remote or underserved areas. Limited availability of infusion centers can result in long travel times and additional costs, particularly for rural populations. This dependence on specialized facilities also makes the treatment less adaptable to emergencies or disruptions, such as natural disasters or pandemics, where access to healthcare may be limited. For patients seeking autonomy in managing their condition, this reliance on clinical settings can be a significant drawback.
10. Slower Post-Treatment Recovery
While Remicade’s infusion-based delivery provides rapid onset of action, the recovery period after each session can be taxing for some patients. Fatigue, dizziness, or mild flu-like symptoms are common side effects that may last for several hours or days following an infusion. These post-treatment effects can interfere with work, social activities, or caregiving responsibilities, reducing the overall appeal of the medication. For individuals already managing the challenges of a chronic condition, the added burden of recovery after each infusion can negatively impact their quality of life.
Conclusion
Choosing between Humira and Remicade requires a careful evaluation of each medication’s benefits and challenges, as both offer unique advantages for treating autoimmune conditions. Humira stands out for its convenience, allowing patients to self-administer the medication at home with minimal disruption to their daily lives. Its biweekly dosing schedule, reduced infusion-related risks, and comprehensive patient support programs make it an appealing choice for individuals seeking flexibility and autonomy. However, Humira’s drawbacks, including potential pain during injections, high costs, and the risk of developing antibodies, highlight the importance of individualized treatment plans.
On the other hand, Remicade provides a powerful option for patients with severe or treatment-resistant conditions, offering rapid symptom relief through its intravenous administration. The controlled clinical setting ensures immediate medical supervision, reducing risks for patients who require close monitoring. Despite these advantages, Remicade’s infusion process is time-intensive, less convenient, and dependent on healthcare facilities, making it less practical for some patients. The higher risk of infusion reactions and long-term financial burden are additional factors to consider.
Ultimately, the choice between Humira and Remicade depends on the patient’s medical history, lifestyle, and personal preferences. Consulting with a healthcare provider is essential to determine the most suitable option, ensuring effective management of the condition while minimizing potential risks. By understanding the pros and cons of each medication, patients can make informed decisions and take a proactive role in their treatment journey.