Don't worry. You wil get your all orals in plenty of time. You are fortunate to be F-1 at age 66. We will just call you "Lucky Liver" from now on. :)
As much as Interferon sucks it is possible that it slowed your rate of fibrosis progression. This doesn't happen for everyone but it does for some (in rare cases it can accelerate liver disease).
-- Edited by Isiscat2011 on Thursday 26th of June 2014 06:45:14 AM
znobs said
Jun 26, 2014
Isiscat2011 wrote:
znobs wrote:
ABBVie showed 95% + SVR for Genotype 1b nonresponders to previous interferon treatments like me. I was able to tolerate interferon and ribavirin but the viral load did not decrease by 2 log after 12 weeks of tx.
If you are trying to figure out whether you will be eligible for all orals the answer is probably yes.
The only way this wouldn't happen is if the SOC is not interferon free and an interferon combo has been proven effective for your genotype. For example, if Interferon and Sovaldi is effective with nonresponder 1bs, and the SOC still includes Interferon, then you wouldn't get all orals unless you also qualified as Interferon intolerant. The term Interferon Intolerant is defined but there is some wiggle room.
The interconnection between the medical community and the insurance companies is pivotal because the med comm determines the SOC and the insurance companies are obligated to pay for SOC tx.
I'm done w/ interferon period. I'm looking forward to one or two DAA pills for 3 months for SVR.
Isiscat2011 said
Jun 26, 2014
znobs wrote:
ABBVie showed 95% + SVR for Genotype 1b nonresponders to previous interferon treatments like me. I was able to tolerate interferon and ribavirin but the viral load did not decrease by 2 log after 12 weeks of tx.
If you are trying to figure out whether you will be eligible for all orals the answer is probably yes.
The only way this wouldn't happen is if the SOC is not interferon free and an interferon combo has been proven effective for your genotype. For example, if Interferon and Sovaldi is effective with nonresponder 1bs, and the SOC still includes Interferon, then you wouldn't get all orals unless you also qualified as Interferon intolerant. The term Interferon Intolerant is defined but there is some wiggle room.
The interconnection between the medical community and the insurance companies is pivotal because the med comm determines the SOC and the insurance companies are obligated to pay for SOC tx.
znobs said
Jun 26, 2014
ABBVie showed 95% + SVR for Genotype 1b nonresponders to previous interferon treatment like me. I was able to tolerate interferon and ribavirin but the viral load did not decrease by 2 log after 12 weeks of tx. My liver is Stage 1 so I can wait till next year for the tx.
-- Edited by znobs on Thursday 26th of June 2014 05:57:10 AM
-- Edited by znobs on Thursday 26th of June 2014 06:07:17 AM
Isiscat2011 said
Jun 26, 2014
znobs wrote:
I would have to get the information from an insurance broker assigned to the organization I am associated with. Also, I can check potential insurance companies to see if FDA approved DAAs like Sovaldi and Olysio are covered. If they are, there's a good chance that ABBVie & SL will be covered as well.
Careful. They are tricky little buggers. They aren't going to give away the goodies that easily. Most will pay for what is cheaper.
znobs said
Jun 26, 2014
I would have to get the information from an insurance broker assigned to the organization I am associated with. Also, I can check potential insurance companies to see if FDA approved DAAs like Sovaldi and Olysio are covered. If they are, there's a good chance that ABBVie & SL will be covered as well.
Isiscat2011 said
Jun 26, 2014
znobs wrote:
I'm looking at starting tx again early next year. My last two failed ( PEG-interferon/Ribavirin [1998] and HCV-796 [2007])
It might make more sense to try to get in on the S/L combo in the two months before the ABBVie is approved. That way the insurance company will not have an alternative for interferon intolerants.
S/L will be the only on label alternative available from October 10th thru Dec. A very small window of opportunity. With a supportive doctor you might just squeeze through that window.
Of course, if you don't have a tx preference, it doesn't matter. You will get the one the insurance co will pay for--probably ABBVie.
Isiscat2011 said
Jun 26, 2014
How will you know in advance which insurance companies will cover what treatments?
Insurance companies are creating new policy provisions and medical societies are creating new guidelines as we speak.
znobs said
Jun 26, 2014
I'm going to switch my insurance during the open season in December to one that will (hopefully) cover ABBVie and S/L. I may end up paying higher premium for next year but it would be worth it. I'm looking at starting tx again early next year. My last two failed ( PEG-interferon/Ribavirin [1998] and HCV-796 [2007])
-- Edited by znobs on Thursday 26th of June 2014 05:27:28 AM
Isiscat2011 said
Jun 25, 2014
I got the impression that my doc thinks ABBVie will be priced lower and those who can't get Sovaldi right away will have access to the ABBVie combo instead. She seemed to be ok with that idea because both combos have comparable SVR rates. We didn't discuss it in depth, however.
I think access depends to a large extend on the medical community. Once new medical guidelines are in place insurance companies will be obliged to pay for whatever the SOC is.
If the SOC has options, like we saw when Teleprevir and Bociprevir were approved simultaneously, then insurance companies may pay for whatever is less expensive. This could cause Gilead to lower the price for the S/L combo.
Teleprevir and Bociprevir were priced comparably so it really became a physician preference. They initially prefered Teleprvir primarily due to the shorter tx time. Once they saw the side effects, however, Teleprevir sales decreased dramatically.
Unfortunately for us patients, it will take time to see how each new DAA combo delivers in terms of efficacy and safety. My money is on Sovali as the backbone of any combo, at least until something better comes along, but that could be a while. The next big thing will probably be in how to shorten treatment times.
Fireman Rob said
Jun 25, 2014
That's great news. Let's just hope insurance will cover it and that game changes soon thereafter.
jimbob said
Jun 25, 2014
That's very good news Isis. There are going to be some really fortunate people coming out to treat during that period - if their iinsurance is cooperative. I wonder if news of the Abbvie release will knock the S/L price down any,if at all.
Isiscat2011 said
Jun 25, 2014
Hey Guys:
I just met with my hepc doc at the Liver Center at Virginia Mason in Seattle. She informed me that not only is their team expecting to begin prescribing the S/L combo immediately after its Oct 10 approval (and it should be on the shelves almost immediately too) but also she fully expects the ABBVie combo to be approved this year--in December--as well.
Don't worry. You wil get your all orals in plenty of time. You are fortunate to be F-1 at age 66. We will just call you "Lucky Liver" from now on. :)
As much as Interferon sucks it is possible that it slowed your rate of fibrosis progression. This doesn't happen for everyone but it does for some (in rare cases it can accelerate liver disease).
-- Edited by Isiscat2011 on Thursday 26th of June 2014 06:45:14 AM
I'm done w/ interferon period. I'm looking forward to one or two DAA pills for 3 months for SVR.
If you are trying to figure out whether you will be eligible for all orals the answer is probably yes.
The only way this wouldn't happen is if the SOC is not interferon free and an interferon combo has been proven effective for your genotype. For example, if Interferon and Sovaldi is effective with nonresponder 1bs, and the SOC still includes Interferon, then you wouldn't get all orals unless you also qualified as Interferon intolerant. The term Interferon Intolerant is defined but there is some wiggle room.
The interconnection between the medical community and the insurance companies is pivotal because the med comm determines the SOC and the insurance companies are obligated to pay for SOC tx.
ABBVie showed 95% + SVR for Genotype 1b nonresponders to previous interferon treatment like me. I was able to tolerate interferon and ribavirin but the viral load did not decrease by 2 log after 12 weeks of tx. My liver is Stage 1 so I can wait till next year for the tx.
-- Edited by znobs on Thursday 26th of June 2014 05:57:10 AM
-- Edited by znobs on Thursday 26th of June 2014 06:07:17 AM
Careful. They are tricky little buggers. They aren't going to give away the goodies that easily.
Most will pay for what is cheaper.
I would have to get the information from an insurance broker assigned to the organization I am associated with. Also, I can check potential insurance companies to see if FDA approved DAAs like Sovaldi and Olysio are covered. If they are, there's a good chance that ABBVie & SL will be covered as well.
It might make more sense to try to get in on the S/L combo in the two months before the ABBVie is approved. That way the insurance company will not have an alternative for interferon intolerants.
S/L will be the only on label alternative available from October 10th thru Dec. A very small window of opportunity. With a supportive doctor you might just squeeze through that window.
Of course, if you don't have a tx preference, it doesn't matter. You will get the one the insurance co will pay for--probably ABBVie.
How will you know in advance which insurance companies will cover what treatments?
Insurance companies are creating new policy provisions and medical societies are creating new guidelines as we speak.
I'm going to switch my insurance during the open season in December to one that will (hopefully) cover ABBVie and S/L. I may end up paying higher premium for next year but it would be worth it. I'm looking at starting tx again early next year. My last two failed ( PEG-interferon/Ribavirin [1998] and HCV-796 [2007])
-- Edited by znobs on Thursday 26th of June 2014 05:27:28 AM
I got the impression that my doc thinks ABBVie will be priced lower and those who can't get Sovaldi right away will have access to the ABBVie combo instead. She seemed to be ok with that idea because both combos have comparable SVR rates. We didn't discuss it in depth, however.
I think access depends to a large extend on the medical community. Once new medical guidelines are in place insurance companies will be obliged to pay for whatever the SOC is.
If the SOC has options, like we saw when Teleprevir and Bociprevir were approved simultaneously, then insurance companies may pay for whatever is less expensive. This could cause Gilead to lower the price for the S/L combo.
Teleprevir and Bociprevir were priced comparably so it really became a physician preference. They initially prefered Teleprvir primarily due to the shorter tx time. Once they saw the side effects, however, Teleprevir sales decreased dramatically.
Unfortunately for us patients, it will take time to see how each new DAA combo delivers in terms of efficacy and safety. My money is on Sovali as the backbone of any combo, at least until something better comes along, but that could be a while. The next big thing will probably be in how to shorten treatment times.
That's great news. Let's just hope insurance will cover it and that game changes soon thereafter.
Hey Guys:
I just met with my hepc doc at the Liver Center at Virginia Mason in Seattle. She informed me that not only is their team expecting to begin prescribing the S/L combo immediately after its Oct 10 approval (and it should be on the shelves almost immediately too) but also she fully expects the ABBVie combo to be approved this year--in December--as well.