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Hep C Discussion Forum -> Knowledge/Info Section -> FYI Insurance 2 costly hepatitis C drugs get insurance restrictions
Post Info TOPIC: FYI Insurance 2 costly hepatitis C drugs get insurance restrictions
Harvoninme


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RE: FYI Insurance 2 costly hepatitis C drugs get insurance restrictions
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I share your thoughts on the matter, Pamela.  However, I personally would have gladly taken whatever was available years ago but was denied the opportunity. At least patients will have a choice: treat now or wait.  I'm curious how this will play out and will be keeping an eye on the Hepc News. 
pamelajean wrote:
lilbit wrote:

Seems to me this is exactly what we needed to happen. If Abbvie is going to make deals then Gilead will have to also. And in the wind, it doesn't mean you can't get treatment, just means you might have to take Abbvie instead. I know everyone wants Harvoni but if i couldn't get it i would definitely settle for the Pak. Good success rate and not that hard to do. I know, I just finished it.

It's great they say they will tx regardless of level of damage....but! The only ones not required to add ribavirin to 3D are 1b's without cirrhosis. The fact they would require me to take RIBA when Harvoni is available doesn't sit well with me. 

To be honest, I don't like it when anyone gets between me and my doc...pharma, gov, etc etc...silly me. :) 

 



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Rubye


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I am so curious as to what, if anything, Gilead will do. One thing that's puzzling to me is I know Gilead has offered large discounts to many state Medicaids on the condition that there be no priority treatment or that everyone get treated. Oregon declined this discount because they didn't want the financial burden of treating everyone. So, I wonder now if they instead made a deal with AbbVie. And if so, if they will start treating people on Medicaid. Finally.

Imo, Gilead's silence is calculated and I am looking forward to when they finally say something. Kind of like when God speaks eh?



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UNDETECTED 5/4/15 - 16 weeks after EOT, 1st treatment - Sovaldi and Olysio, Geno 1a, 67 year old with compensated cirrhosis, over 40 years with HCV.
lilbit


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Rubeye that is the way I understood it also. There are going to be exceptions, there will have to be. There are people on life saving prescriptions that won't interact well with the drugs. There are people that do not tolerate Riba. It sounded to me like if you could prove it would be detrimental to you it could be appealed. I personally am excited that they will treat people early. I have read all the horror stories of all the treatments and how sick everyone is before getting treatment. It breaks my heart to know what all they have gone through and all the relapses. I have watched my husband go through two year long rounds of treatment that completely destroyed his health. And he still has HepC. The perfect world will be when the day you are diagnosed you start treatment and get it over with right away. For a few people Abbvie could do just that. Hopefully Gilead will step up and jump in the pool price wise so that people can get what they want instead of being told what they can get. It truley should be what your doctor feels in the best possible treatment for your circumstances.

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64 yo Diagnosed in 1991 with Hep C, Genotype 1a, VL close to 16,000,000, Tx Abbvie Topaz II 9/5/14, Wk 2 and 4 und. End of treatment 11/27/14 undetected.  EOT+4 und  EOT+12 und.  EOT+24 und CURED, EOT +52 now I feel really cured.
Rubye


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If I understand this correctly, then because I'm treating with Sovaldi/Olysio I will not be able to do the AbbVie pak. In this case, Express Scripts would go ahead and pay for Harvoni for me if I should relapse. Does that sound right?

This looks like it could eventually be a good thing in that more people can treat rather than just cirrhotics. For those of us with Medicaid, in some states nothing may change with regard to who gets treated first.

I did read just a little while ago on Seeking Alpha that since many state Medicaids already receive a discount of something like 23% that Abbvie will probably not go below these already discounted rates. And, in a state like mine my guess is the drugs may still only go to those with cirrhosis. Just a guess.



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UNDETECTED 5/4/15 - 16 weeks after EOT, 1st treatment - Sovaldi and Olysio, Geno 1a, 67 year old with compensated cirrhosis, over 40 years with HCV.
Bills


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Sorry to say i'm a pessimist
Yes I'm on Harvoni and grateful that i am  It wasn't just the interferon free and riba free that sold me it was the success for hard to treat. With my trac record I was about to do anything that promised me high 90%'s or take up drinking again. Just kidding.
i also fully agree we should not be told what treatment is best for us based on price. If i had Express Scripts I'd be scared to death ( mind I'm in  the hard to treat PI relapses range ) For those of you who are naive step right up.  
I love how responsive everyone is with follow up data to post stuff we need to take into account about whats out here It's so hard to find Dr's who would really take the time to understand (What is best for this person vs another )
This looks like the beginning of a very long thread   And Thank you all for you opinions and help here
Bill S
pamelajean wrote:
It's great they say they will tx regardless of level of damage....but! The only ones not required to add ribavirin to 3D are 1b's without cirrhosis. The fact they would require me to take RIBA when Harvoni is available doesn't sit well with me. 

To be honest, I don't like it when anyone gets between me and my doc...pharma, gov, etc etc...silly me. :) 

lilbit wrote

Seems to me this is exactly what we needed to happen. If Abbvie is going to make deals then Gilead will have to also. And in the wind, it doesn't mean you can't get treatment, just means you might have to take Abbvie instead.



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Bills

Harvoni started 12-12-14 for 24 wks PrevTX Geno 1 stage 3 cirrhosis - non resp Int/ ribv. Started Trial  in Aug 2011 -July 2012 into Incivek relapsed  Feb 2013 Had 72 weeks on interferon & Riba.

pamelajean


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lilbit wrote:

Seems to me this is exactly what we needed to happen. If Abbvie is going to make deals then Gilead will have to also. And in the wind, it doesn't mean you can't get treatment, just means you might have to take Abbvie instead. I know everyone wants Harvoni but if i couldn't get it i would definitely settle for the Pak. Good success rate and not that hard to do. I know, I just finished it.

It's great they say they will tx regardless of level of damage....but! The only ones not required to add ribavirin to 3D are 1b's without cirrhosis. The fact they would require me to take RIBA when Harvoni is available doesn't sit well with me. 

To be honest, I don't like it when anyone gets between me and my doc...pharma, gov, etc etc...silly me. :) 



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pamelajean


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Bills wrote:

Am reading that correctly ?

Express Scripts said Monday that it will no longer cover Sovaldi and Harvoni starting Jan. 1, except under limited circumstances.

Instead, it will make AbbVie Inc.s Viekira Pak, approved Friday, the preferred treatment for patients who have the most common form of hepatitis C, genotype 1.

Is that the Preferred drug? for the G1 Hard to teat cirrhotics who relaped more than once?

I may have missed discussions on ABBVIE success rates in testing

Can Anyone comment on the success rates for the relapses?

 

thanks

BS

AbbVie 3D was only tested with those that relapsed from interferon/ribavirin and not PI's. 

According to the new AASLD guidelines, the Abbvie 3D regimen is NOT recommended for those who failed the PIs....so it appears Harvoni will still be available with Express if what they say is true. "Patients who are already on the drugs will still be covered, and those with other types of hepatitis C and advanced liver disease can still get Sovaldi." 

-----------------
Recommended regimen for patients without cirrhosis who have HCV genotype 1 infection, regardless of subtype, in whom a prior PEG-IFN, RBV, and HCV protease inhibitor regimen has failed. 

Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) for 12 weeks is recommended for retreatment of patients without cirrhosis who have HCV genotype 1 infection, regardless of subtype, in whom a prior PEG-IFN, RBV, and HCV protease inhibitor regimen has failed. 

Rating: Class I, Level A 

Two options with similar efficacy in general are recommended for patients with cirrhosis who have HCV genotype 1 infection, regardless of subtype, in whom a prior PEG-IFN, RBV, and an HCV protease inhibitor regimen has failed. 

Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) for 24 weeks is recommended for retreatment of patients with cirrhosis who have HCV genotype 1 infection, regardless of subtype, in whom a prior PEG-IFN, RBV, and HCV protease inhibitor regimen has failed. 

Rating: Class I, Level A 

Daily fixed-dose combination ledipasvir (90 mg)/sofosbuvir (400 mg) plus weight-based RBV (1000 mg [75 kg]) for 12 weeks is recommended for retreatment of patients with cirrhosis who have HCV genotype 1 infection, regardless of subtype, in whom a prior PEG-IFN, RBV, and HCV protease inhibitor regimen has failed. 

Rating: Class IIa, Level B 

 

The following regimens are NOT recommended for patients with HCV genotype 1 infection, in whom prior treatment that included an HCV protease inhibitor has failed. 

    Any regimen containing PEG-IFN, including 

        Simeprevir, PEG-IFN, and RBV 

        Sofosbuvir, PEG-IFN, and RBV 

        Telaprevir or boceprevir, PEG-IFN, and RBV 

        PEG-IFN and RBV alone 

    Rating: Class IIb Level A 

    Monotherapy with PEG-IFN, RBV, or a direct-acting antiviral 

    Rating: Class III, Level A 

    Any interferon-free regimen containing an HCV protease inhibitor 

        Simeprevir 

        Paritaprevir 

    Rating: Class IIb, Level A 


http://hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed



-- Edited by pamelajean on Monday 22nd of December 2014 02:48:18 PM 



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Bills


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Am reading that correctly ?

Express Scripts said Monday that it will no longer cover Sovaldi and Harvoni starting Jan. 1, except under limited circumstances.

Instead, it will make AbbVie Inc.s Viekira Pak, approved Friday, the preferred treatment for patients who have the most common form of hepatitis C, genotype 1.

Is that the Preferred drug? for the G1 Hard to teat cirrhotics who relaped more than once?

I may have missed discussions on ABBVIE success rates in testing

Can Anyone comment on the success rates for the relapses?

 

thanks

BS



__________________

Bills

Harvoni started 12-12-14 for 24 wks PrevTX Geno 1 stage 3 cirrhosis - non resp Int/ ribv. Started Trial  in Aug 2011 -July 2012 into Incivek relapsed  Feb 2013 Had 72 weeks on interferon & Riba.

lilbit


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Seems to me this is exactly what we needed to happen. If Abbvie is going to make deals then Gilead will have to also. And in the wind, it doesn't mean you can't get treatment, just means you might have to take Abbvie instead. I know everyone wants Harvoni but if i couldn't get it i would definitely settle for the Pak. Good success rate and not that hard to do. I know, I just finished it.


__________________

64 yo Diagnosed in 1991 with Hep C, Genotype 1a, VL close to 16,000,000, Tx Abbvie Topaz II 9/5/14, Wk 2 and 4 und. End of treatment 11/27/14 undetected.  EOT+4 und  EOT+12 und.  EOT+24 und CURED, EOT +52 now I feel really cured.
inthewind


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In my opinion delay of treatment will not be cost effective. And could incur higher cost caused by the delay in treatment later if a transplant or other complications come into play. 



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Tig


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Let the battles begin....

Tig



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Tig

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inthewind


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http://www.bostonglobe.com/business/2014/12/22/express-scripts-turns-abbvie-huge-hepatitis-deal/lIZmKNKuX9plF801Hk00bJ/story.html



-- Edited by inthewind on Tuesday 23rd of December 2014 05:08:48 PM

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