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Hep C Discussion Forum -> On Treatment -> Harvoni Alternatives
Post Info TOPIC: Harvoni Alternatives
Cinnamon Girl


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RE: Harvoni Alternatives
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Hi Phil, welcome from me too and thanks for helping out! 

As Tig has already said, you`re welcome to start a new thread (`start a new topic`) in the New Members Area to introduce yourself to us or just join in wherever you like, this is a very friendly group! 



__________________

Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
pdcorlis


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Thank you Tig And Congratlations Lon!



-- Edited by pdcorlis on Thursday 19th of February 2015 08:40:35 PM



-- Edited by pdcorlis on Thursday 19th of February 2015 08:40:53 PM

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Gator Man


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Hi Lon,

I know that your good news was all due to the positive karma generated from this forum. biggrin

Congratulations, Lon, SVR will be here before you know it!



__________________

Geno 1b, compensated cirrhotic, 54 yo, prior null responder. Pre tx VL approx 595,000, tx with Sovaldi/Olysio (no Riba) started 1/8/14. VL 40 @ 2 weeks, UND @ 4 weeks. Still UND @ EOT + 1 year.

Gator Man SVR12, Dragon 0, Final Score.
Cinnamon Girl


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Fantastic news, Lon, so pleased for you!!  biggrin 

Let us know when you start, we`ll be here to cheer you on along your journey! 

 



__________________

Jill 

(71 yo, lives in UK)

Was Gen 3a, 

24wks Peg Ifn/Riba, Sep 2010 - Mch 2011

UND @ Wk.4, UND @ EOT, 

SVR Nov 2011 --> Still UND @ EOT + 4 yrs.

 

 
Tig


Admin

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Lon,

Congratulations! That didn't take long, WOOT! Now on to SVR! Good luck!

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

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Lon


Veteran Member

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All,

I got word from my GI today that I was approved for 8 weeks of treatment.  What a relief!

Lon



__________________

(Geno type 1, VL 3 million, stage 2-3, took (8) weeks of Harvoni that completed on May 1, 2015, I'm showing undetectable today)

"Everyday is a gift, that's why they call it the present."
Tig


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Hi Phil,

Welcome to the forum! Thanks for the tip. If you would like to review several available payment assistance programs, you can find them via the link in my signature or in our Knowledge section on the homepage. The search function will help you with additional information as well.

Please feel free to share your story using our New Members section. We'd enjoy hearing more! I'm glad you're here!

Tig



__________________

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

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pdcorlis


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If you are fighting with your insurance company - please remember to check MySupportPath.com - Gilead's support arm. They not only offer help with co-pays but if you have been denied twice by your insurance company, you and your Dr. can apply for the Patient Assistance Program. If you qualify - the will cover the cost of your medication. They do not care about your fibrosis level and as long as your income is below $100,000 for a family of two you will meet the financial requirement. The forms can be downloaded from their site.

good luck and may we all be treated sooner rather than later.



-- Edited by pdcorlis on Thursday 19th of February 2015 06:53:30 PM

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Tig


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Hey Tess,

Thank you for posting that information! It's vital that we share information like this because it is such a morale booster for those waiting or trying for approval. It shows that the ice is starting to thaw! I've got my fingers crossed Lon! Good luck!

Tig    



__________________

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

 
Lon


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Thank you.  This is great news!



__________________

(Geno type 1, VL 3 million, stage 2-3, took (8) weeks of Harvoni that completed on May 1, 2015, I'm showing undetectable today)

"Everyday is a gift, that's why they call it the present."
Tess


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Lon - maybe things are looking up...  

http://www.seacoastonline.com/article/20150201/News/150209982

Harvard Pilgrim negotiates discount on hepatitis C drug

WELLESLEY, Mass. - Harvard Pilgrim Health Care announced it is the first regional health plan in New England to negotiate a discount with Gilead Sciences Inc., the maker of the new hepatitis C drug Harvoni, which will result in millions of dollars in savings for its customers and help to slow the growth of escalating health care costs....

Harvoni is the preferred drug for patients with Genotype I. Harvard Pilgrim will continue to cover other drugs when clinically appropriate. The Harvoni discount will apply to patients with liver fibrosis scores of F2-F4, or about 58 percent of the HCV population.

"This is a win, win for patients, for employers who subsidize their employees' health insurance, and for all who have a stake in ensuring that the dollars we spend on health care are used wisely," Sherman said. "We are proud to be the first regional carrier in New England to negotiate this savings so that our members have access to the best drugs available to treat their disease."



__________________

HCV Gen 1a diagnosed 2001; Labs 11/13/14: VL 1.2 million IU/mL, ast 88, alt 111. Harvoni TX 12 weeks.  EOT - 2/18/15, VL UND & normal ast/alt.

4 wks after EOT, VL = UND; normal AST/ALT at 4, 8 and 14 weeks after EOT.  15 weeks after EOT = Undetectable!
Tess


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Hi Lon (Pats fan?!) 

What I found, at least with my insurance, is that the plan's specialty pharmacy decides whether or not to approve drugs like Harvoni.  So when choosing an insurance plan, knowing the specialty pharmacy's criteria for approval is key.  Another thing that might help at some point is Gilead's coupon for Harvoni that reduces the patient's co-payment to only $5.  It was very easy to get - - no financial information was required.

Yesterday was the end of my 12 weeks on the golden bullet and I went for blood work today.  I won't be considered cured for awhile but am thinking positive!  I do feel better emotionally and energetically.  I think my memory has been better too!   Best of luck getting on the Harvoni train Lon!

- Tess



__________________

HCV Gen 1a diagnosed 2001; Labs 11/13/14: VL 1.2 million IU/mL, ast 88, alt 111. Harvoni TX 12 weeks.  EOT - 2/18/15, VL UND & normal ast/alt.

4 wks after EOT, VL = UND; normal AST/ALT at 4, 8 and 14 weeks after EOT.  15 weeks after EOT = Undetectable!
Fireman Rob


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Hi Lon,

CVS Pharmacy does have a contract Harvoni. I would steer clear of United Health Care as they have done nothing to help me.  I hear Blue Cross is good to cover treatment.

Let us know what you decide. Good luck!

-Rob



__________________

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

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


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Thanks Tess,

I'm not a federal employee but I'm very glad to hear that your approval went smoothly.  I'm in Boston and I have Harvard Pilgrim.  My application went in on January 6th and I'm fighting with them daily.

What the insurance companies don't know is that people like me have been waiting for a cure for the past 30 years.  Being on the phone everyday for the next 18 months is nothing to me.  biggrin

I feel for the insurance companies, I really do.  They are trying to stay afloat.  I'm happy Gilead came up with a cure.   Still patients with this disease who pay for health insurance deserve to be cured.  

The dynamics of the whole thing are pretty interesting.  Getting angry is a waste of of my energy.  I would rather kill them with kindness.  If I have to take every health insurance prescription authorizer to lunch and make my case, I will.

Do you feel more energetic and clearer headed now that you're cured?

Lon

 

 

 



__________________

(Geno type 1, VL 3 million, stage 2-3, took (8) weeks of Harvoni that completed on May 1, 2015, I'm showing undetectable today)

"Everyday is a gift, that's why they call it the present."
Tess


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Lon wrote:

....

Also does anyone know which insurance companies are the easiest to obtain Harvoni prescription authorization?  Next November I will have an option to change health insurance providers.  Knowing which ones are approving would help point me in the right direction.

Thanks,

Lon

 Hi Lon,

Are you a Federal employee?  I ask because November is open season so it seems like you might be.  I am, and I had a smooth ride getting approved for Harvoni.  My plan is Blue Cross Blue Shield FEP Basic Option.  The specialty pharmacy is CVS Caremark although I don't know if it's different depending on where you are in the country.  I'm in Rhode Island.  My doctor sent in the prior approval form and I was approved very quickly.  

I found this forum during open season when I was looking for info on insurance plans that would approve Harvoni.  It turned out that the one I was already on worked great.

For Caremark's Harvoni criteria and PA form- - 

https://www.caremark.com/wps/portal/WEBSUPPORT_FAQS?cms=CMS-PWCM-2034779

Good luck!

- Tess



__________________

HCV Gen 1a diagnosed 2001; Labs 11/13/14: VL 1.2 million IU/mL, ast 88, alt 111. Harvoni TX 12 weeks.  EOT - 2/18/15, VL UND & normal ast/alt.

4 wks after EOT, VL = UND; normal AST/ALT at 4, 8 and 14 weeks after EOT.  15 weeks after EOT = Undetectable!
pl1952


Senior Member

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Hi Lon, I'm in the same position as you -- battling my insurance company, United Healthcare, for 1 1/2 months.  They denied Harvoni, basically saying I'm not sick enough.  We just filed an appeal this week.  Another long wait I'm sure is in store for me...There's someone on here shadowcats10 who gave excellent and easy step by step instructions on what to do after receiving 2 denials from your insurance company by going through Gilead Support Path.  That's my plan.  I'm just waiting though.  I feel your frustration..



__________________

Me: 62 yr. old female, GT 1b, fibroscan 4.5; VL 650,975 as of 2/4/14;started Harvoni 3/6/15; SVR


Hubby: 59 yrs.; GT1b; fibroscan 25-cirrhotic; S/O for 12 weeks started tx 3/20/14; SVR56; fibroscan done 7-7-15 = 8.5
Gator Man


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Lon wrote:

 

Also does anyone know which insurance companies are the easiest to obtain Harvoni prescription authorization?  Next November I will have an option to change health insurance providers.  Knowing which ones are approving would help point me in the right direction.

 

Hi Lon,

I spotted this recently in a Wall Street Journal blog:

"Gilead has nailed contracts with Anthem, CVS Caremark, OptumRx, Catamaran, Cigna and Wellcare. These deals give its Harvoni and Sovaldi hepatitis C treatment either preferred or exclusive formulary status, according to a tally prepared by Deutsche Bank analyst Robyn Karnauskas."

Preferred or exclusive formulary status does not guarantee approval, but if you satisfy the insurance co.'s criteria for tx, you would get Harvoni or Sovaldi from the above providers. Although i had a battle with Anthem and CVS Caremark regarding a prescription refill, the initial authorization for Sovaldi and Olysio was not a problem, much to my surprise although I am a F4.

You might want to check out Fireman Rob's post from last May about battling to get S/O approval:

I'm definitely going to change insurance companies during "Open Season" which isn't until November for me. I just hope I can change with this new discovered "pre-existing condition."

From the research I've done, this is an Express Scripts decision to force the drug companies to lower their prices. So any insurance tied to Express Scripts will likely be the same until prices drop from competition. Like you, it's going to be very trying to wait that long. I'm currently applying for assistance through Gilead's Support Path. I hope and pray they help me with Sovaldi. Janssen was really good to work with. 

Those "evil" drug companies are turning out to be not so evil. Without them, I wouldn't have any avenue to work through with my income level. I bet Blue across would be better as my experience really couldn't be any worse than UHC's wait for severe Cirrhosis Plan.

I'll keep you posted on my attempt to get Sovaldi through the drug company . 

 

Tig is correct, things are changing fast. Good luck and let us know how we can do to help.

john

 

 

 



-- Edited by Gator Man on Wednesday 18th of February 2015 03:27:32 PM



__________________

Geno 1b, compensated cirrhotic, 54 yo, prior null responder. Pre tx VL approx 595,000, tx with Sovaldi/Olysio (no Riba) started 1/8/14. VL 40 @ 2 weeks, UND @ 4 weeks. Still UND @ EOT + 1 year.

Gator Man SVR12, Dragon 0, Final Score.
Lon


Veteran Member

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Thank you.



__________________

(Geno type 1, VL 3 million, stage 2-3, took (8) weeks of Harvoni that completed on May 1, 2015, I'm showing undetectable today)

"Everyday is a gift, that's why they call it the present."
Tig


Admin

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Hi Lon,

I'm sorry to hear you're having these issues with insurance and obtaining Harvoni. I might suggest you discuss the possibility of getting assistance from the Gilead Support Path program. After two denials and the appropriate appeals have been made, you and your doctor can request their help and get it. The information for many of these programs is via the link in my signature or via our search function/Home links.

There is also the new protocol, Viekera Pak by Abbvie. It's another very effective protocol available now. I'll leave a link. It's a little less and may be something your healthcare team is willing to look at.

As far as new things on the horizon, Gilead has yet another coming, Sovaldi and GS5816. A pan genotypic protocol, but Gilead doesn't release anything that's less expensive...sadly.

The availability of preferred insurance carriers is in the air really. Some approve immediately and some make you pull teeth for approval. My best suggestion is to search our pages and listen to our membership. You will surely be hearing from others regarding your question on that.

Keep your hopes up, because things are changing fast. I hope to see these insurance carriers ease up some this year, due to public and Congressional pressure. I also hope to see some more affordable protocols in the near future. Good luck, Lon...

Tig

http://www.abbvie.com/content/dam/abbviecorp/us/

desktop/contentrooms/downloads/ProductFactsheetViekiraPak_US.pdf



__________________

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

 
Lon


Veteran Member

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Hello,

I've been battling the insurance companies for the past 2 months trying to get Harvoni authorized.  My viral load is 3.5M and my staging is 2+.  My insurance company is only approving 3+ liver disease staging.

It seems that once another effective combo drug comes onto the market, Gilead's monopoly and throat choke on the insurance companies wallets will be finally be over.

Are there any new effective Hep C drug combinations on the horizon that might be a less expensive alternative to Harvoni?

Also does anyone know which insurance companies are the easiest to obtain Harvoni prescription authorization?  Next November I will have an option to change health insurance providers.  Knowing which ones are approving would help point me in the right direction.

Thanks,

Lon



__________________

(Geno type 1, VL 3 million, stage 2-3, took (8) weeks of Harvoni that completed on May 1, 2015, I'm showing undetectable today)

"Everyday is a gift, that's why they call it the present."
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