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Hep C Discussion Forum -> On Treatment -> Lab Frequency and Ins. Coverage?
Post Info TOPIC: Lab Frequency and Ins. Coverage?
Huey


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RE: Lab Frequency and Ins. Coverage?
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longld wrote:

The normal lab routine of every two weeks for a CBC and a monthly CMP was prescribed.  Viral load was at 12 weeks and 24 weeks on a 24 wk treatment (Gen3).  These labs moved to a weekly due to wanting to keep closer attention to what they believe is the first kidney transplant patient on Sovaldi.  Also anemia (two transfusions so far) added to the weekly necessity.  ie. depends on your unique characteristics and how yu respond to treatment.....

 I am a Geno 3 as well , no transplant, I am on week 14 , I get lab test for liver function once a month and see a nurse, VL tested twice, will test one more time wile on treatment, at EOT, and 12 weeks later for SVR.  mine is a routine no surprises kind of experience.  Hope yours is as well.



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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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The normal lab routine of every two weeks for a CBC and a monthly CMP was prescribed.  Viral load was at 12 weeks and 24 weeks on a 24 wk treatment (Gen3).  These labs moved to a weekly due to wanting to keep closer attention to what they believe is the first kidney transplant patient on Sovaldi.  Also anemia (two transfusions so far) added to the weekly necessity.  ie. depends on your unique characteristics and how yu respond to treatment.....



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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
suziq


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Hi,

The frequency of my viral load tests on my clinical trial is in my signature.  It was frequent at first--then every 4 weeks.  My final VL test will be July 1--actually 25 weeks after EOT.  Was supposed to be 24 weeks, but oh well.  I think the 4 week test adds to the comfort of the patient and then again at 8 weeks if the 4 week was not UND.  That is what I think, but have no idea what the insurance companies think (or don't bother to think).  If you have the money (in case insurance won't pay) then whatever makes you and your doctor comfortable, especially if you are slow to reach UND.  Every week seems excessive to me once UND is established. 

SuziQ



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Geno 1A  Age 82 Treatment naive Cirrhotic Told I had liver disease in 1966. Diagnosed as Hep C 1999.Started Merck clinical trial with Riba on 9/9/2013 Week 1 and 2 <25  Weeks 4, 8, 12,16,18 UND.  EOT Jan 14,2014  EOT +12 UND   JULY 1 2014 EOT+24= SVR
Tig


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Hey Rob,

Every two weeks is a frequent routine, I'm curious what that will entail? Before you allow them to perform a viral load on a biweekly basis, I would preauthorize it with your insurance carrier. During my Tx, they performed a VL test too frequently one month and my insurance company balked and said it was unnecessary. I'm still waiting on the determination of my appeal over the payment. The VL can run anywhere from $1000-1800 bucks each, so you can understand why they want some control over the frequency.

Tig

PS: Happy testing!! (Pincushions unite!)  biggrin



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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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Fireman Rob


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Thanks for your input Tig and Isiscat.  After talking to my medical assistant, it sounds like I'm their first patient that will be on the Sovaldi/Olysio regimen.  They indicated my labs would be the same as if I was doing the traditional treatments for Genotype 1 (every two weeks).  This info definitely provides me with some thoughts on how to approach this when the time comes if needed.

Thanks Much!



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Age 33, Male. GT-1 for ten years. Diagnosed in March, 2014.

Treated with Sovaldi/Olysio: SVR 24 on February 16, 2015!
Isiscat2011


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Tig56 wrote:

I've seen some doctors request full labs, including a viral load every two weeks, which imo is excessive unless there's a specific need warranting it. 

It does seem a bit excessive.  I think some docs will do this more because the patient wants it than for the clinical value.  It is a bedside manner thing but I would make sure the insurance co will pay before I started accumulating VL tests (and bills).  



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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.
Tig


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Hi Rob,

This is a difficult question to answer! I've been searching for a futility rule for Sovaldi and it doesn't exist. I've seen some doctors request full labs, including a viral load every two weeks, which imo is excessive unless there's a specific need warranting it. At the same time I'm seeing more and more reports of only a EOT viral load and then a EOT +12 to confirm SVR. I think that it's a question to have with your doctor and see what he plans on doing. Often the viral load, due to it's cost is a decision that is preauthorized with your insurance carrier. Were I you, I'd "like" to have one at week 4 and if undetectable, another at EOT and EOT +12. If you are still detectable at week 4, then I'd want another one at week 8. What I truly wish is that they would establish an algorithm, like they did with Incivek and Victrelis. If you weren't undetectable by an established time, they stopped treatment. But that's the deal with Sovaldi, it happens fast, but it seems to do it's "thing" between week 4 and 8. I don't remember seeing anyone still detectable after week 8 (on Sovaldi). I believe that's why some doctors are only doing the VL at EOT and at +12. Certainly during treatment, maybe every 4 weeks, it's good to have a CBC and maybe a liver panel to determine if anemia is a factor during treatment. Bring it up with your doc, it's a good thing to know.

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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Fireman Rob


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Hi All,

Just wondering what everyone's experience has been with labs while taking the Sovaldi/Olysio combo and if insurance is covering them at regular intervals once Tx begins? 

I'm curious about what's considered excessive labs as I'm trying to learn about all the newest  protocols with the new meds.

Thanks! 



__________________

Age 33, Male. GT-1 for ten years. Diagnosed in March, 2014.

Treated with Sovaldi/Olysio: SVR 24 on February 16, 2015!
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