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Hep C Discussion Forum -> On Treatment -> Olysio/solvaldi panicking over INSURANCE SUDDEN CHANGE
Post Info TOPIC: Olysio/solvaldi panicking over INSURANCE SUDDEN CHANGE
Omnamahshivaya


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RE: Olysio/solvaldi panicking over INSURANCE SUDDEN CHANGE
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Thank you all for your immeasurable support. I'm panicking far less and slept deep last night. thank you. xo OMJ

 

I'll keep you all posted what happens....



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Isiscat2011


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Omnamahshivaya wrote:

Thanks Isicat;

That's what my husband is saying. I truly hope you're right. thank you. Yes, I'm sure my doctor will help as he was super pleased with my results last week and very onto of my treatment. Thank you. 

Your husband is right.  Your doctor's office will help you get your script filled if need be.  Also remember that he would almost certainly have quick access to a sufficient supply to tide you over until your full prescription shipment arrived, if it ever came to that.    

But, it won't come to that.  Concentrate on the progress you are making every day and don't even worry about this.  



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Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Barnacle


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Thanks for the heads up. Just emailed the clinic to ensure my final shipment has arrived. One more bottle of each and I'm done like dinner.
I'll post here if there are any issues


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57yo male gen 1a since '70s. Fib F3-4 VL >2M Tx started 5 Apr 14 Sov/Oly/Rib

wk 4 UND wk 8 UND, wk 12 EOT UND...keep em coming 24wks UND = SVR!
Tig


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Hi J,

I agree with Isis completely. We've witnessed this kind of unethical behavior played out over and over with Accredo and several others since the Sov/Oly off label protocol was established. Why they set up a program that split up the distribution process for the last month is absurd and as we've all witnessed, it has made a confusing mess of the process. Each time we've seen this occur here on the forum, it has been resolved in time to receive the last month's delivery. We've even seen some of these pharmacies try to deliver an extra month of medications after treatment was over! They've got a long way to go to figure out how to treat people properly. It's going to be fine, try to rest easy tonight, tomorrow will be a better day!

Tig



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

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Omnamahshivaya


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Thanks Isicat;

That's what my husband is saying. I truly hope you're right. thank you. Yes, I'm sure my doctor will help as he was super pleased with my results last week and very onto of my treatment. Thank you. 



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Isiscat2011


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Hi Omna:

You will receive your second month Wednesday,  which means there is still an entire month for your doctor's office, the pharmacy, and the insurance company to work out month three and they will.  

Do not stress over it.   Worrying about it at this point is a complete waste of your energy and will only upset you.   Just keep your eye on the ball; it will be fine.



__________________

Diagnosed in 2011, Incivek triple in 2011, tx discontinued, Genotype 1a, CT, VL 7mill, cirrhosis dx in 2012, age 67, waiting for new DAAs.
Omnamahshivaya


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feels shady. " second amended complaint, filed in January, alleges pharmacies BioScrip, CVS, Accredo Health Group Inc. and CuraScript Inc. engaged in Novartis kickback schemes."

 

http://www.law360.com/articles/530588/cvs-decries-novartis-kickback-suit-as-implausible

 

is what my insurance doing mid-treatment LEGAL?



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
longld


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RE: Olysio/solvaldi PANICING over INSURANCE SUDDEN CHANGE
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I doubt that any pharmacy would give you more than 30 days supply at a time, especially of Sovaldi.  Is anybody on the Forum getting more than 30 days at a time?



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62 Yrs Old, CHC Geno 3, Cirrhosis, Kidney Transplant (13 yrs), On Sovaldi/Riba Treatment (24 week) since Feb 01,2014

Viral Load 7M on 1/8/2014,  UND at EOT 7/18/2014
Omnamahshivaya


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I've been getting them from a different pharmacy. And tomorrow I will still get my second to last dose from a different pharmacy than Accredo. So screw Accredo.



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Huey


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I beleave this Accredo is the only place you can get it right now.  I work sorting mail sometimes some of the same packages like we get with our meds from Accredo,

The only Drug store that has it!  And they are a hassle 



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
Omnamahshivaya


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My doc set it all up the same way you said. It was basically FREE for this protocol. I didn't ask many questions; just was grateful. And started treatment with the understanding that I'd only be paying $30 a month co-pay for both Olysio and Solvaldi combined for all three months.

My insurance has suddenly changed their "rules" and are now requiring patients to use Accredo. That's all I know so far. My local pharmacy will send me the second month wednesday but now the last and final month is up in the air with this sudden change mid-treatment.

 



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Huey


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I have CIGNA and I Pay 160 a month in prem. thats 80 every two weeks, but I got the High dollar prem not deductible/low co0pay plan knowing what i was going to do.  My Doctor set up all the insurance and approval and they are covering it, I also got the Glead co=pay cupon and i pay only 5 per sovalidi and 12 for the ribovirin.  all my test and low office co pay.  I dont think your insurance is this robust but the sovaldi co=pay should be the same , $5



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
Omnamahshivaya


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I'm pretty sure it's still Blue Cross. PPO.



-- Edited by Omnamahshivaya on Tuesday 20th of May 2014 03:39:17 AM

__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Omnamahshivaya


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Posts: 107
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Thank you Tig and everyone. I will read what you sent me over the next few days and do everything in my power to change this; it's just hit my heart hard -- like it was all too good to be true.

The good news is the pharmacy who initially was solely charging me $30 co-payment is also willing to help fight this battle for me.

My insurance is through Blue Cross. It's a PPO. Hope that helps. 

If all of this doesn't work, let's hope I can be cured after two months.... b/c there's no way we can afford $22,000. 

I wish I read the threads earlier and had my current pharmacy get me all the meds upfront which at first they were going to do.

Thank you all. So disappointing on the flip-side of such great news of nearly cured in two weeks. 

I guess the insurance company doesn't want to fork over the $ once they realized how much it costs. Guess they should think it through first prior to approving a patient's treatment and switch-and-baiting it midway through. Is it even legal?

Thanks everyone. I'll look into all of this in the new two days when my husband is home to help watch my little one.

Thank you.

OMJ



__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
Tig


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Hi J,

Here we go again! This is an ongoing problem with several people here and I was hoping that after the first several reports of trouble and resolutions, these pharmacies and the insurance companies involved in screwing things up over and over, would finally get it straight. Evidently not. I simply don't understand why simply common sense is so difficult to remember. Obviously the ability to irritate people and screw them at every turn comes natural, yet doing the right thing is impossible to do without continual reminders.

 I want you to go over the posts in the thread I'm going to provide. We have a member Envigo, that went through the whole process and has some very good suggestions. Pay attention to the section where she contacted Gilead's My Support Path. They are a patient assistance program established by the manufacturer of Sovaldi. They have helped people on many occasions and may be able to assist you as well. Go over this information and let me know if you have any questions. I'll do whatever I can to get this ball rolling forward again, but lets get started right away. Don't get too stressed out, we'll do our best to get this resolved, okay? Hang in there!

http://hepcfriends.activeboard.com/t57099534/express-scripts-debacle/

My Support Path (Gilead)

Support Path for SovaldiŽ, please call, call 1-855-769-7284 

Tig



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Tig

68yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 9+ years!

Hep C FAQ   Lab Ref. Ranges  HCV Resistance

Signature Line Set Up/Abbreviations   Payment Assistance

 
Huey


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I Don't know what the A C C stands for ,, But I totally get the reDo part!



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  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
longld


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Yes, that is Accredo pharmacy - also didn't mention name of lame insurance company - some of us might have experience or can do research if we knew that.   Don't panic - like Huey, I believe they can get this straightened out....



__________________

62 Yrs Old, CHC Geno 3, Cirrhosis, Kidney Transplant (13 yrs), On Sovaldi/Riba Treatment (24 week) since Feb 01,2014

Viral Load 7M on 1/8/2014,  UND at EOT 7/18/2014
Huey


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Nothing starts my Riba-Rage up faster than That ACC REDO Pharmacy,, I Can only tell you to hang in there, It worked out for me and I think it will for you too. The Co=Pay doesn't sound right, Your Doctors Med, Assistant can work this out. Good Luck, And Hang in there!

__________________

  HCV Genotype 3a , now Psot-Tx was on S/riba. First VL was 5.8 mil on 7-5-13 then "und" at 3.8 weeks. 06/13/14 still und. off meds 3 days back on 7/29 Last pill 08/10/14 SVR+4

 
Omnamahshivaya


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Olysio/solvaldi panicking over INSURANCE SUDDEN CHANGE
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Hi;

I was approved for the Olysio/Solvaldi treatment for three months. My insurance agreed to pay, the pharmacy my doctor found had coupons to cover $2,500.00 for the rest and my co-pay each month is only $30. That's why I jumped on it and say yes. 

I'm now almost a month through and just contacted my pharmacy for the second round, and they are very nice there but told me that my insurance company SUDDENLY decided on MAY 1 that I have to use a different pharmacy ACCREO, for the last month and the co-pay for the final dose will be $22,000!!!!!!

I'm already having issues sleeping and stressed. the meds are working like a gem and now the INSURANCE LAME company switched their policy mid-treatment and are trying to get me to pay something they didn't agree on prior to me starting. I can't pay $22,000. I can't even pay $2,000. And I don't want to only do two months of treatment even though I'm nearly UD.

Anyone else have this pulled on them? My current pharmacy is going to try to help me get the last dosage from them but i have no idea if it will work. UGGGGGGGGGGGGGGGGG

 



-- Edited by Omnamahshivaya on Tuesday 20th of May 2014 03:38:56 AM



-- Edited by Omnamahshivaya on Tuesday 20th of May 2014 03:42:50 AM

__________________

OMJ - started treatment April 25, 2014

Prior to treatment VL 14 million. Liver Levels Abnormal but under 70.

Sovaldi/Olysio

VL: SOT = 14 million.    SOT +2 weeks = 28

AST/ALT: Normal

Week # 7 = UND
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