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Post Info TOPIC: SkyeMed Pharmacy
Huey


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RE: SkyeMed Pharmacy
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skewedButNotBroken wrote:

Isiscat2011 Wrote:

 If your insurance will pay for off label S/O then they will pay for FDA approved S/L (you are considered Highest Priority under the new AASLD guidelines). S/L is considered the better tx option for 1as. We are only about 7 weeks away from having the S/L option...


--Isiscat, I know I should wait, but I feel miserable everyday. I guess I'm just sick and tired of being sick and tired. I feel like my head is in a drum. I feel like I'm being slowly poisoned. I feel like I have the flu. My ears ring like when a person is very sick. My eyes have no moisture in them. My back itches severely like I've got fleas or something. My joints ache. My energy level is low. I get irritated very easily. My brain seems like it does not work like it used to, etc. etc. I have such high hopes that treatment will turn things around for me and so if I can start even a few weeks early--I'm ready.

Oh, by the way, thanks Huey I applied for and received that Sovaldi coupon through email.



-- Edited by skewedButNotBroken on Friday 22nd of August 2014 11:03:20 PM

I pushed the LIKE button



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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

 
skewedButNotBroken


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Thanks Tig, I just applied for the Olysio coupon.



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Diag. with hep c in 1992; A3:F2;  GT 1a; IL28B CT; VL 900k, ALT 150, AST 100 on 8/5/2014; SOT 9/5/2014  S/O ---VL 127 after 6 days; VL detected on day 18 but < 15.; --> UND @ EOT+ 1 year SVR!
Tig


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Hi Testiva,

As you move forward with treatment options, I want to point out some additional payment assistance programs that are available. Not only can you obtain assistance for the backbone drugs, like Sovaldi, but the secondary meds, like Ribavirin, etc., are also covered by these organizations. We have a list here on the forum that we like to keep updated as new programs and medications come available. The PAN Foundation is particularly helpful. Good luck...

http://hepcfriends.activeboard.com/t56904226/payment-assistance-programs/

Tig

 

Anyone with additional programs or information that can be added to this list, please let me know and we can get them incorporated to the list. Thank you!



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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

 
Isiscat2011


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I'm sorry you are feeling so poorly, skewedButNotBroken.  Hopefully, the letter from your doc will get you the tx and you can get started very soon.   Well done on the coupon.  



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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.
skewedButNotBroken


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Isiscat2011 Wrote:

 If your insurance will pay for off label S/O then they will pay for FDA approved S/L (you are considered Highest Priority under the new AASLD guidelines). S/L is considered the better tx option for 1as. We are only about 7 weeks away from having the S/L option...


--Isiscat, I know I should wait, but I feel miserable everyday. I guess I'm just sick and tired of being sick and tired. I feel like my head is in a drum. I feel like I'm being slowly poisoned. I feel like I have the flu. My ears ring like when a person is very sick. My eyes have no moisture in them. My back itches severely like I've got fleas or something. My joints ache. My energy level is low. I get irritated very easily. My brain seems like it does not work like it used to, etc. etc. I have such high hopes that treatment will turn things around for me and so if I can start even a few weeks early--I'm ready.

Oh, by the way, thanks Huey I applied for and received that Sovaldi coupon through email.



-- Edited by skewedButNotBroken on Friday 22nd of August 2014 11:03:20 PM

__________________

Diag. with hep c in 1992; A3:F2;  GT 1a; IL28B CT; VL 900k, ALT 150, AST 100 on 8/5/2014; SOT 9/5/2014  S/O ---VL 127 after 6 days; VL detected on day 18 but < 15.; --> UND @ EOT+ 1 year SVR!
Isiscat2011


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I thought you were F-3.  Sorry.  Not sure how much that changes things for you, though.  (F-2 are considered "high" rather than "highest" priority.)  If insurance is willing to pay for S/O I can't see why they wouldn't pay for S/L. 



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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.
Isiscat2011


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If your insurance will pay for off label S/O then they will pay for FDA approved S/L (you are considered Highest Priority under the new AASLD guidelines).   S/L is considered the better tx option for 1as.  We are only about 7 weeks away from having the S/L option.

I'm just curious whether you were aware of all this and why you wouldn't opt for the S/L combo instead.  Please don't be offended.  Just wondering. 



__________________

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


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I just talked to my doctor's office and they said BCBS has denied the request and that Dr. Martin wrote a letter of necessity yesterday and not to worry because denials on the first attempt are to be expected.



__________________

Diag. with hep c in 1992; A3:F2;  GT 1a; IL28B CT; VL 900k, ALT 150, AST 100 on 8/5/2014; SOT 9/5/2014  S/O ---VL 127 after 6 days; VL detected on day 18 but < 15.; --> UND @ EOT+ 1 year SVR!
longld


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The good news is that you are dealing with a Speciality Pharmacy and they should know the ropes.  Mine wnet through BCBS and required a conf call with dr but went through in about 2-3 weeks - BCBS was great to deal with and paid for everything!



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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
Isiscat2011


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skewedButNotBroken wrote:

Hello Everyone. Two weeks ago my doctor submitted a script to SkyeMed Pharmacy for Sovaldi/Olysio and they are tasked with squeezing the money out of BCBS (a tall order). I was wondering about how long will it take before I get my first denial or if I get really lucky an approval?

Thanks

Hi Skewed:

How long the pre-authorization process takes is a very individual thing.  There are 3 parties involved: the doc, the insurance co, and the pharmacy. Depends on how fast and accurately they can all work together.  Pre-authorization for specialty drugs can take a week or it can take a month or more.  

This is a particularly tricky time because the insurance companies are waiting for the drug pricing on the S/L combo which will be known by Oct. 10.  No doubt they are looking even further down the road to the Abbvie combo which will be out in December. They are also awaiting the AASLD guidelines.

Obviously, if the S/L combo is cheaper than the S/O combo they will prefer to pay for that; the S/L combo is also much better studied and not off-label which simplifies things a bit more.  If the Abbvie combo is cheaper than the S/L combo then they may try to hold some 1a patients off for that.

The good news is that as an F-3 you are in the "Highest Priority" classification under the updated AASLD guidelines.  So, even if you don't get S/O, you should be treated fairly fast and in all likelihood with all oral DAAs.   Good luck!

 



-- Edited by Isiscat2011 on Thursday 21st of August 2014 09:01:41 PM

__________________

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


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Go to Gilead and get the Sovaldi coupon,  makes your co-pay 5 and you don't even get billed for that. At least i didn't,.



__________________

  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

 
skewedButNotBroken


Senior Member

Status: Offline
Posts: 189
Date:
Permalink  
 

Hello Everyone. Two weeks ago my doctor submitted a script to SkyeMed Pharmacy for Sovaldi/Olysio and they are tasked with squeezing the money out of BCBS (a tall order). I was wondering about how long will it take before I get my first denial or if I get really lucky an approval?

Thanks



__________________

Diag. with hep c in 1992; A3:F2;  GT 1a; IL28B CT; VL 900k, ALT 150, AST 100 on 8/5/2014; SOT 9/5/2014  S/O ---VL 127 after 6 days; VL detected on day 18 but < 15.; --> UND @ EOT+ 1 year SVR!
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