Thanks for that list of links. We have a list here and I will add this information to it. We can't have too much of a good thing!! I wish I had known about these programs years ago. It would help greatly if these manufacturers would consider making their products affordable in the first place. The price of good health and life in general shouldn't be limited to those that can afford it...
Tig
suziq said
Apr 17, 2014
This is an excellent list of patient assistance programs available for the FDA approved Sovaldi (Gilead) and Olysio (Johnson and Johnson) All other drugs are still only available through clinical trials at this time in U S.
If you're searching for Payment Assistance programs, there is a link in my signature section that links you to the forum thread (Knowledge Section) that lists several available options. Good luck!
Tig
suziq said
Apr 16, 2014
This is the info on GileadOne program, the Sovaldi Co-Pay Coupon Program, is the low-cost solution Gilead is pushing for the hardest. Under the program, patients are told they will pay no more than $5 in out-of-pocket expenses according to a Gilead spokesperson. But that coupon only applies to patients who have a health insurance program and only covers 20 percent of the catalog price of the drug, or $12,000 of the regimens $84,000 cost.
The phone number to Bristol Myers Program for Olysio is 800-736-0003.
Check them out. Some people are paying under $25 a month for their meds.
There are other programs for people without insurance as well.
SuziQ
patiently_waiting said
Apr 16, 2014
OS, thanks for the info. Looks like it would cost me roughly $170/month out of pocket with my policy, assuming I got authorized for it. They'd be on the hook for nearly $60K per month. No wonder they're raising hell.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 10:27:59 PM
OldenSlow said
Apr 16, 2014
patiently_waiting wrote:
I'm curious what experiences folks have had in getting approved for the Sovaldi/Olysio combo, given it's off-label. I've read several reports here of people getting approved and some who haven't. I'm thinking maybe we can compile a list of who is approving and who isn't. I'll start the list with one post I read about UHC (please correct me if I'm mistaken). I'm new here so moderators if this already exists elsewhere or is otherwise inappropriate feel free to take it down. :)
UHC - will only approve if geno 1 and there's evidence of stage 3 or 4 fibrosis
Cigna - this is what I have...anyone know their policy?
Sun Life (Canada) - covers it (I think...correct me if I misunderstood Barnacle)
others...
Hi PW and welcome to the forum. With the ongoing cost/coverage chaos, this is proving to be a real can of worms. The various insurors are still trying to get a handle on things, Medicaid's a mess (Texas is already limiting coverage there), Express Scripts is waging a vendetta against Gilead and the future is filled with question marks. More unknowns that knowns, honestly. At least UHC published their treatment guidelines, so you know where you stand with those guys. I have Anthem Bc/Bs and have had no issues, though others have. Cigna's formulary is here:
They show both Sovaldi and Olysio available as third tier drugs, with prior authorization required. You'd have to refer to your benefit plan for further details. Hoping you can get involved in the trials that SuziQ mentioned. That would be a nice way to sidestep the coverage nonsense.
Best of luck to you.
wayne
Barnacle said
Apr 16, 2014
patiently_waiting wrote:
Barnacle wrote:
In Canada I am covered by employee health plan (Sun Life) they had no issue approving Tx. Dr says it will be at least a year before publin health plan approves sovaldi and may never approve off-label
Just so you know I had to put my foot down to convince my Dr that my health plan would cover it. He seemed skeptical, nurse went away to make phone calls a minute or so later I'm signing application papers. Tell your Dr what you want.
Hi Barnacle. I didn't quite understand...is Sun Life the insurance company who covers you or the place where you're employed?
Sun Life is my health care insurance company. I work for the Federal Government and this health care is provided to all public service employees. Many of whom are not aware they have one of the best health plans in the country. I was not aware until I saw how easy it was to get very expensive off-label treatment that is not available through the public health care.
patiently_waiting said
Apr 16, 2014
suziq wrote:
Hi Patiently Waiting,
I would suggest that you call immediately. The lists fill up quickly. You can always refuse when/if you get called. But if the list is filled, any opportunity is lost. I know Merck will be doing several phase 3 trials there this Spring. They have had great results That is the trial I just finished. And I am SVR now. They have also done some Gilead trials. I was refused for that trial BUT Gilead did a free biopsy for me. Turned out I had progressed to cirrhosis and the trial was for non-cirrhotics. Got screened for my Merck trial one day after my 79th birthday. What a great present. The coordinator there actually had us come in at midnight so we could be first on the nationwide list. It was first come/first serve on the slots. Our names went in one minute after midnight and everyone eligible got a slot.
Getting on the list is the most important thing---you can ask questions later---before you accept the trial offered. There is someplace in Dallas that offered some trials last year, but I don't remember where.
SuziQ
Got it, thank you. EDIT: Just called...spoke with a very nice lady...she said she wasn't sure if they were taking relapsers or not but she would check and get back to me. Thanks again, SuziQ, very much for giving me that info.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 08:49:20 PM
suziq said
Apr 16, 2014
Hi Patiently Waiting,
I would suggest that you call immediately. The lists fill up quickly. You can always refuse when/if you get called. But if the list is filled, any opportunity is lost. I know Merck will be doing several phase 3 trials there this Spring. They have had great results That is the trial I just finished. And I am SVR now. They have also done some Gilead trials. I was refused for that trial BUT Gilead did a free biopsy for me. Turned out I had progressed to cirrhosis and the trial was for non-cirrhotics. Got screened for my Merck trial one day after my 79th birthday. What a great present. The coordinator there actually had us come in at midnight so we could be first on the nationwide list. It was first come/first serve on the slots. Our names went in one minute after midnight and everyone eligible got a slot. These are not double blind trials. All participants get the meds. There may be a difference in treatment length depending on your treatment/non-treatment status or cirrhosis status. Everyone on the trial I did there reached SVR.
Getting on the list is the most important thing---you can ask questions later---before you accept the trial offered. There is someplace in Dallas that offered some trials last year, but I don't remember where.
SuziQ
-- Edited by suziq on Wednesday 16th of April 2014 08:40:31 PM
patiently_waiting said
Apr 16, 2014
suziq wrote:
Hi Patiently Waiting
Since you live in Texas also, my clinic is doing a number of new clinical trials in the very near future--including trials from Merck (the trial I just finished)
If you live anywhere near Dallas, it is the Texas Clinical Research Institute in Arlington Texas. 817-471-1070 Also, San Antonio does trials as does Houston. I know that Abbott has done some trials in San Antonio.
It is nice not to have to deal with insurance and get paid to cure HepC. The people at my center were really great and stayed involved during my treatment. When I was rejected for one trial, they found another for me. I was never made to feel like "just another patient" or that my questions were bothersome. It was a very positive experience.
SuziQ
Thanks for the info, SuziQ. I am in the DFW metro area so that may be a good option for me. I will likely see what my doc has to say and if I'm not given good options I could start looking for a trial. Are these Phase 3 and participants are guaranteed to get actual meds (not placebo) I assume?
suziq said
Apr 16, 2014
Hi Patiently Waiting
Since you live in Texas also, my clinic is doing a number of new clinical trials in the very near future--including trials from Merck (the trial I just finished)
If you live anywhere near Dallas, it is the Texas Clinical Research Institute in Arlington Texas. 817-471-1070 Also, San Antonio does trials as does Houston. I know that Abbott has done some trials in San Antonio.
It is nice not to have to deal with insurance and get paid to cure HepC. The people at my center were really great and stayed involved during my treatment. When I was rejected for one trial, they found another for me. I was never made to feel like "just another patient" or that my questions were bothersome. It was a very positive experience.
SuziQ
patiently_waiting said
Apr 16, 2014
Barnacle wrote:
In Canada I am covered by employee health plan (Sun Life) they had no issue approving Tx. Dr says it will be at least a year before publin health plan approves sovaldi and may never approve off-label
Just so you know I had to put my foot down to convince my Dr that my health plan would cover it. He seemed skeptical, nurse went away to make phone calls a minute or so later I'm signing application papers. Tell your Dr what you want.
Hi Barnacle. I didn't quite understand...is Sun Life the insurance company who covers you or the place where you're employed?
Barnacle said
Apr 16, 2014
In Canada I am covered by employee health plan (Sun Life) they had no issue approving Tx. Dr says it will be at least a year before publin health plan approves sovaldi and may never approve off-label
Just so you know I had to put my foot down to convince my Dr that my health plan would cover it. He seemed skeptical, nurse went away to make phone calls a minute or so later I'm signing application papers. Tell your Dr what you want.
patiently_waiting said
Apr 16, 2014
I'm curious what experiences folks have had in getting approved for the Sovaldi/Olysio combo, given it's off-label. I've read several reports here of people getting approved and some who haven't. I'm thinking maybe we can compile a list of who is approving and who isn't. I'll start the list with one post I read about UHC (please correct me if I'm mistaken). I'm new here so moderators if this already exists elsewhere or is otherwise inappropriate feel free to take it down. :)
UHC - will only approve if geno 1 and there's evidence of stage 3 or 4 fibrosis
Cigna - seems to be a covered, 3rd tier medication but not sure what policy is on individual approval yet
Sun Life (Canada) - covers it (I think...correct me if I misunderstood Barnacle)
EDIT: As I look into this more it seems making a list is a waste of time as there are too many variables.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 07:17:57 PM
-- Edited by patiently_waiting on Wednesday 16th of April 2014 07:18:42 PM
-- Edited by patiently_waiting on Wednesday 16th of April 2014 10:19:53 PM
Hi Susan,
Thanks for that list of links. We have a list here and I will add this information to it. We can't have too much of a good thing!! I wish I had known about these programs years ago. It would help greatly if these manufacturers would consider making their products affordable in the first place. The price of good health and life in general shouldn't be limited to those that can afford it...
Tig
This is an excellent list of patient assistance programs available for the FDA approved Sovaldi (Gilead) and Olysio (Johnson and Johnson) All other drugs are still only available through clinical trials at this time in U S.
Hepatitis PAP and Co-Pay Programs : Patient Assistance and Co ...
www.hepmag.com/articles/hepatitis_paps_copays_20506.shtml
SuziQ
If you're searching for Payment Assistance programs, there is a link in my signature section that links you to the forum thread (Knowledge Section) that lists several available options. Good luck!
Tig
This is the info on GileadOne program, the Sovaldi Co-Pay Coupon Program, is the low-cost solution Gilead is pushing for the hardest. Under the program, patients are told they will pay no more than $5 in out-of-pocket expenses according to a Gilead spokesperson. But that coupon only applies to patients who have a health insurance program and only covers 20 percent of the catalog price of the drug, or $12,000 of the regimens $84,000 cost.
The phone number to Bristol Myers Program for Olysio is 800-736-0003.
Check them out. Some people are paying under $25 a month for their meds.
There are other programs for people without insurance as well.
SuziQ
OS, thanks for the info. Looks like it would cost me roughly $170/month out of pocket with my policy, assuming I got authorized for it. They'd be on the hook for nearly $60K per month.
No wonder they're raising hell.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 10:27:59 PM
Hi PW and welcome to the forum. With the ongoing cost/coverage chaos, this is proving to be a real can of worms. The various insurors are still trying to get a handle on things, Medicaid's a mess (Texas is already limiting coverage there), Express Scripts is waging a vendetta against Gilead and the future is filled with question marks. More unknowns that knowns, honestly. At least UHC published their treatment guidelines, so you know where you stand with those guys. I have Anthem Bc/Bs and have had no issues, though others have. Cigna's formulary is here:
Cigna Formulary
They show both Sovaldi and Olysio available as third tier drugs, with prior authorization required. You'd have to refer to your benefit plan for further details. Hoping you can get involved in the trials that SuziQ mentioned. That would be a nice way to sidestep the coverage nonsense.
Best of luck to you.
wayne
Sun Life is my health care insurance company. I work for the Federal Government and this health care is provided to all public service employees. Many of whom are not aware they have one of the best health plans in the country. I was not aware until I saw how easy it was to get very expensive off-label treatment that is not available through the public health care.
Got it, thank you. EDIT: Just called...spoke with a very nice lady...she said she wasn't sure if they were taking relapsers or not but she would check and get back to me. Thanks again, SuziQ, very much for giving me that info.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 08:49:20 PM
Hi Patiently Waiting,
I would suggest that you call immediately. The lists fill up quickly. You can always refuse when/if you get called. But if the list is filled, any opportunity is lost. I know Merck will be doing several phase 3 trials there this Spring. They have had great results That is the trial I just finished. And I am SVR now. They have also done some Gilead trials. I was refused for that trial BUT Gilead did a free biopsy for me. Turned out I had progressed to cirrhosis and the trial was for non-cirrhotics. Got screened for my Merck trial one day after my 79th birthday. What a great present. The coordinator there actually had us come in at midnight so we could be first on the nationwide list. It was first come/first serve on the slots. Our names went in one minute after midnight and everyone eligible got a slot. These are not double blind trials. All participants get the meds. There may be a difference in treatment length depending on your treatment/non-treatment status or cirrhosis status. Everyone on the trial I did there reached SVR.
Getting on the list is the most important thing---you can ask questions later---before you accept the trial offered. There is someplace in Dallas that offered some trials last year, but I don't remember where.
SuziQ
-- Edited by suziq on Wednesday 16th of April 2014 08:40:31 PM
Thanks for the info, SuziQ. I am in the DFW metro area so that may be a good option for me. I will likely see what my doc has to say and if I'm not given good options I could start looking for a trial. Are these Phase 3 and participants are guaranteed to get actual meds (not placebo) I assume?
Hi Patiently Waiting
Since you live in Texas also, my clinic is doing a number of new clinical trials in the very near future--including trials from Merck (the trial I just finished)
If you live anywhere near Dallas, it is the Texas Clinical Research Institute in Arlington Texas. 817-471-1070 Also, San Antonio does trials as does Houston. I know that Abbott has done some trials in San Antonio.
It is nice not to have to deal with insurance and get paid to cure HepC. The people at my center were really great and stayed involved during my treatment. When I was rejected for one trial, they found another for me. I was never made to feel like "just another patient" or that my questions were bothersome. It was a very positive experience.
SuziQ
Hi Barnacle. I didn't quite understand...is Sun Life the insurance company who covers you or the place where you're employed?
Just so you know I had to put my foot down to convince my Dr that my health plan would cover it. He seemed skeptical, nurse went away to make phone calls a minute or so later I'm signing application papers. Tell your Dr what you want.
I'm curious what experiences folks have had in getting approved for the Sovaldi/Olysio combo, given it's off-label. I've read several reports here of people getting approved and some who haven't. I'm thinking maybe we can compile a list of who is approving and who isn't. I'll start the list with one post I read about UHC (please correct me if I'm mistaken). I'm new here so moderators if this already exists elsewhere or is otherwise inappropriate feel free to take it down. :)
EDIT: As I look into this more it seems making a list is a waste of time as there are too many variables.
-- Edited by patiently_waiting on Wednesday 16th of April 2014 07:17:57 PM
-- Edited by patiently_waiting on Wednesday 16th of April 2014 07:18:42 PM
-- Edited by patiently_waiting on Wednesday 16th of April 2014 10:19:53 PM