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Hep C Discussion Forum -> On Treatment -> I'm No longer Ranting I am finally on the Harvoni Train. Time to slay a Dragon.
Post Info TOPIC: I'm No longer Ranting I am finally on the Harvoni Train. Time to slay a Dragon.
JimmyK


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I'm No longer Ranting I am finely on the Harvoni Train. Time to slay a Dragon.
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The Specialty Pharmacy will ship in a cooled container and of course require a signature.

That the motivation is money is beyond debate. If you run in to trouble a Specialty Pharmacy is by far a better advocate.

Generally speaking, a Specialty Pharmacy will arrange a brief interview prior to each shipment.

It looks like both are on board for a 12 week course.

From what you are saying here Wall-greens seems a bit unprofessional.

There is little profit with a pharmacy in dispensing drugs, but there is a profit. The cost to fill and dispense remains fairly level regardless of if it is a $5 prescription or a $50 one.

Wall-Greens likely buys direct from Gilead and they would pay a wholesale price while charging Insurance the retail rate.

Given the retail cost, the profit margin of filling an 84 pill count of Harvoni purchased at wholesale prices is certainly far greater than an 84 pill count of Amoxicillin as an example only designed to create thought.

Of course they want to fill the prescription. Math.

 

JimmyK

 



-- Edited by JimmyK on Friday 26th of May 2017 02:53:11 PM

__________________

Harvoni TX 2 12 weeks. UND weeks 4, 12 and now EOT + 4 Weeks. SVR-12 09/29/16. All Glory, Honor and Thanks be to God.

"I go to war with the brothers I trust."
Canuck


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Yep, hard to say is right! Clear as mud. 8 weeks or 12 weeks. Walgreen or specialty pharmacy. $5.00/$30.00/or $0 co-pay. I wouldn't have a clue who to go with or who would be better? Hate to cancel the guys, whichever ones they were, (who you think) are the ones saying they are going to give you 12 weeks versus 8 weeks - neither has that shoe seemingly landed (whether "approved for 12" may not necessarily mean you will indeed get 12, if 8 looks like it is curing you well). Sorry, beyond me, I can be of no help here. confuse C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Tig


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It's hard to say what their motivation is, but I'd venture to guess it's money. Contact your insurance company and doctor's office. Tell them what's going on and don't sign for the delivery. Your doctor obviously called Walgreens, tell them to un-call them! Cancel the order, but be sure the specialty pharmacy is indeed sending the Rx.

These are deliveries that must be signed for. If they leave a $32K bottle of Harvoni in your mailbox or front porch, somebody isn't doing their job. 



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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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Bilbo626


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So I received an e-mail from the Walgreens that my doctor sent my prescription to today saying my Harvoni was ready and I could pickup my Harvoni at the Walgreens for a copay of $30. The last time I talked to my insurance company they said that Harvoni is a special medication and only could be filled locally for the first prescription because of the strong instance of fraud. All refills must go through Cigna mail delivery pharmacy. So I had Cigna them fill the first prescription, they told me I had 2 refills for a total of 12 weeks and since I had my Harvoni coupon the cost would be $5. Walgreens said I would have 1 refill for a total of 8 weeks. For those of you who came in late. Walgreens is the same Pharmacists that tried to test my insurance by putting in a prescription for amoxicillin which wasnt percribed to see if my. Insurance it would work. They put on that terrible class that told us that the cure rate was now 90%. As well as describing the side effects of Ribovin as wishing you could die. So I called Cigna and asked what was up. They said they would call Walgreens and rescind the approval because it was against their policy and I didn't trust them. Then I get a phone call from Walgreens saying they already shipped my meds to my house. I saidI thought I needed to pick it up? I said I wanted Cigna to send it because that was their policy and I didn't want to pay $30 when I could pay $5. They said they got a foundation to cover the costs so the copay would be $0. I said I didn't apply for any foundation grants nor do I need them use that money on someone who doesn't have insurance or needs the support more than I did. They then told me it was already mailed. They then told me they misinformed me and I had 2 refills coming the second would be sent in another 30 days. This one will also be zero copay. Am I being paranoid or is something going on here. Is this fraud greed or incompetence?

__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
Bilbo626


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So I received an e-mail from the Walgreens that my doctor sent my prescription to today saying my Harvoni was ready and I could pickup my Harvoni at the Walgreens for a copay of $30. The last time I talked to my insurance company they said that Harvoni is a special medication and only could be filled locally for the first prescription because of the strong instance of fraud all refills must go through Cigna mail delivery pharmacy. So I had them fill the first prescription, they told me I had 2 refills for a total

__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
Canuck


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This is turning out a bit harder than you thought eh? Carrying this big "to-do" list around with you constantly, whilst running your biz full-time! 

I am impressed with your juggling act! 

Carry a gal of water, imodium, spare underwear, ibuprofen, box of kleenex for runny nose, leave a trail of gingerbread cookie crumbs whereever you go, to mark your trails between home/work/and frequent loo and lab vists, do not sneeze in your red rubber nose entertaining children, nor during labs when trying to hold in bladder and bowels.

I anxiously await your 2 week lab results too - maybe you will already start to see a wee early drop in your ALT/AST, but betting you will, by the 4 week one!

Your doing a great job (all round) Bilbo! Keep doing it. (And, oh don't I like men who are not afraid of a kitchen!) Try to get some good rest in too tho. Water! biggrin C.  



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
wendyo


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Great post Bilbo. I'm laughing and envious from the rush you had as I never had a high from the harvoni. Damn recovering folk always looking for that!



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Wendy 53 y/o, DX 1994, geno 1A F1

1999 TX 1 - Inter -non responder 2001 TX 2 - Peg + Riba - viral load tripled and taken off

T3:  Harvoni 12 weeks Sept. 19, 2015 ALT 41 AST 30 VL 541800 UND at EOT and SVR 24 ALT 18 AST 26 platelets 223

 
Tig


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I had to laugh about your note to the wife! Forgive me no  I can see you sitting (fidgeting) in your seat as you waited on your lab tests. All I can offer is this sound bit of advice, don't fart and always recon the nearest bathroom. 

Let us know about the tests when you hear something. You're coming up on week 4 and those tests will be amazing. I'm sure of that!

WATER, WATER, WATER!!!

 



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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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Bilbo626


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Well here I am day 18. It has been a wild ride. The side effects have been strange. It's like wheel of fortune. I will have one or two a day but they all have been manageable thanks to ginger, ibuprofen, and Imodium. With the sneezing and running nose most people at work think I'm battling the world's longest cold. The worst was summed up by the text I sent to my wife on Monday "There's no greater joy than waiting to have a blood test with a full blatter and loose stools." The best was when I was feeling that burst of energy from the Harvoni High when I came home from work. I took out the garbage, sorted the recycling, washed all the dishes, scrubbed the kitchen counters and shelves, changed the š± litter, vacuumed. My wife came home and said. "So this would be a good day." Down side with a drippy nose I might not be able to wear my Red nose at work tomorrow for Red nose day. Yes I really do it makes the kids at the garden center happy. Looking forward to the results of my second blood test and getting my second bottle of Dragon slayer. Thanks for all the support you folks are the answer to a prayer.

__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
Tig


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It's important to follow your doctor's orders. If you have explained the importance of your work schedule and the concern for bloodwork still holds the same value, then you know what the plan of the day is! 

There may be additional concerns that we aren't aware of, so my best answer is to always follow your doctor's advice. 



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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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Canuck


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Hi Bilbo,

I really would try VERY hard to have the bloods taken just like your doc suggests, on the timetable he laid out, they ARE very important these tests. (I know you have a lot of work demands, but health trumps all). These tests are the only things that can possibly guide you and your doc to know for certain the drugs are working as they should, that nothing else untoward is happening to you. Labs are very incovenient things to have to do all the time, but most people look forward to the relief in actually geting their first inklings (proof) that all is going to be OK, and that this big investment they have made into their health indeed seems to be paying off. You were lucky to receive a good amount of lab tests (some people are not as well looked after, as what was offered to you). They are the feedback that keeps you safe.

All of tests you listed (below) are important, (from your CBC's to your LFT's to the VL's) I would want them all and on time, week 2 will be very telling if your ALT/AST is begining to crash, week 4 is very important too to continue monitoring to look for an ALT/AST drop, and, to see if your VL is crashing yet. (For me) there is not one of them that I would not want know ASAP, so, I would do all of them, on time, if humanly possible, including week 8, week 12 (not yet defined).  

How are you feeling?? smile C.

Week 1 Diagnosis B18.2 Test CBC\ w Diff Baseline

Week 2 Diagnosis B18.2 Test CBC\ w Diff ,Hepatic Function Panel (AMA)

Week 4 Diagnosis B18.2 Test CBC\ w Diff ,Hepatic Function Panel (AMA),Hepatic c RNA, Quant RT PCR

That's all the Orders I have but I have been told I need Blood Tests at 8 and 12 weeks too I just don't know what.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Bilbo626


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So the doctor kind of insinuated that I need to take the blood tests on exactly the anniversary that I started treatment. How critical is that so I need to take a half day of work to take these tests on time or say I started on a Monday and my day off is Tuesday or Wednesday. Could I take it then?

__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
JimmyK


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Greetings,

I am gathering from the discussion that;

1) "They said and My Doctor said I was approved for 8 weeks of treatment." They being the Doctors Pharmacy, are the first ones to get the prescription. They then submit the claim to the Insurance Company. This is where the Insurance Company gets their Specialty Pharmacy involved effectively transferring the prescription to them.

2) It is possible to have a prior authorization for 8 weeks and have the Specialty Pharmacy show 12 weeks of refills. This is where I have first hand experienced having a Doctor approve me for 24 weeks of Harvoni. The Specialty Pharmacy had refills for the 24 weeks scheduled however 28 days at a time. A complete scheduling of blood letting and other appointments to be conducted throughout the 24 weeks. The Insurance Company ended approval at 12 weeks against my Doctors strong objections and the so called Specialty Pharmacy acting as short stop.

What would not surprise me to see is subsequent to your four week blood draw, if found to be UND at that time, getting shut out of the third bottle of 28 expensive pills. This would be based on the fact that you are qualified for the highly successful 8 week course by nature of your numbers and all related factors.

As time and data progress, the Insurance Companies, who are getting hit hard in this, take advantage of more effective ways to cut cost.

Yes they have to cover you by nature of your policy which is a legal and binding Contract. However they do not have to approve or pay for services rendered beyond the accepted protocol.

Your Insurance Company can make the case that data shows 8 weeks is sufficient in your case. It sounds like the initial order may well have been for 8 weeks at your Doctors Pharmacy.

In my case, the Insurance Company was right. The 12 weeks did it and to be honest in retrospect, I am glad as can be they cut me off. That 5:55 stuff was getting old.

JimmyK



__________________

Harvoni TX 2 12 weeks. UND weeks 4, 12 and now EOT + 4 Weeks. SVR-12 09/29/16. All Glory, Honor and Thanks be to God.

"I go to war with the brothers I trust."
Canuck


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Bilbo,

That is a good blood draw regime.

Additionally, to the schedule you have shown here, if you were on an 8 week course, I would expect an end of treatment (EOT) 8 week PCR, OR, if you were on a twelve week course, I would expect an (EOT) 12 week PCR.

Seems more and more people are getting 8 week treatments nowadays (but when justified by parameters - some of which Tig mentioned). I do wonder how far reaching the insurance dictates go - we had one fellow here fully expecting a long course of harvoni, suddenly and unexpectedly he was informed he did not need the longer course, that a shorter one was all he needed. Perhaps if you fit the "picture" before treatment (the parameters Tig mentioned) AND you DO respond PERFECTLY, EARLY (as proven by your blood draws) - they can make that decision (to shorten your course) while you are still on treatment? Just a thought ... I really have no dea how your system works down there - but that might explain why one pharmacy says 12 the other say 8 - they haven't made up their minds yet?, until the first early blood test jury returns? Maybe "approved" for 12 doesn't necessarily mean you will get 12, depending on your response to treatment, and if no other pre-existing parameters support needing a long course?  No idea, I'm just guessing! 

I just don't want you to be surprised if something like that ever occurred, likely it won't, the main thing is I just  don't want you to be worrying about it - they will NOT allow you to be NOT cured after such an investment in you!, whether it ends up being an 8 or 12 week length. Many people are starting to get 8 weeks courses nowadays, and are being perfectly well cured. Bonus for the patient too, the shorter treatment times. smile C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Tig


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As long as it hasn't left the control of the pharmacy and wasn't opened, it won't vanish! That's worth around $30K, and is under lock and key...



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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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Bilbo626


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My insurance company would only allow 28 days at a local pharmacy all others must be sent directly from the insurance company Pharmacy. It is weird š that a whole month of a very expensive drug was going to just vanish like that š¤

__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
Tig


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Your blood work orders look correct and will tell you exactly how things are progressing. I'm pleased to see an order like that. The 8 and 12 week tests will be on the same order. You will also have them again at the 12th week following the end of treatment to determine if you have achieved SVR.

Looking at your history, you qualify for the 8 week Harvoni treatment. You are treatment naive, viral load is below 6 million, and your low fibrosis stage is a plus. I would opt for the 12 week course as well, if your coverage meets it and seems it has.

The pharmacy issue is strictly financial. There is big money made on these drugs. It's a sad truth, everyone that touches the prescription, makes money. A 12 week course of Harvoni (retail) is approximately $94,500.00. The profit pie is divvied up by all of the players. Many insurance providers don't give you a choice of pharmacies. Unless of course you pay for it out of pocket.



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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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Bilbo626


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I'm No longer Ranting I am finally on the Harvoni Train. Time to slay a Dragon.
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Week 1 Diagnosis B18.2 Test CBC\ w Diff Baseline

Week 2 Diagnosis B18.2 Test CBC\ w Diff ,Hepatic Function Panel (AMA)

Week 4 Diagnosis B18.2 Test CBC\ w Diff ,Hepatic Function Panel (AMA),Hepatic c RNA, Quant RT PCR

That's all the Orders I have but I have been told I need Blood Tests at 8 and 12 weeks too I just don't know what.

The Doctors office is pissed off that I didn't go with their Pharmacy.  Their Pharmacy keeps calling to see if I will transfer the Prescription there.  I wont.  They said and My Doctor said I was approved for 8 weeks of treatment.  I know that I have been approved for 12 because that's what my insurance company's mail order pharmacy is filling.  Something is going on here that doesn't seem right.  I think I would rather take 12 weeks rather than 8.



__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
Canuck


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No longer Ranting on Harvoni
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Hey Bilbo,

Congrats man! 1 out of your 12 weeks of Harvoni done! Glad to see you posting in your very own "On Treatment" thread! Such a long journey for you, to finally get here, on treatment, but you did it!, past all the delays, frustrations and obstacles! Big progress!

You'll see, when this 12 week treatment period is done, you will find this part went fast!, comparatively, to how slow things were moving for you prior.

Tig (and you) are correct in your surmizing and predictions, and we all hope to see you adjust to being on harvoni right shortly, with no big swings in how you are feeling. Sorry about the "cow-killing" headache, hope that does not happen again for you - keep dousing anything like that with water, just like you have been doing. And try not to work too hard. Not overdoing things, rest, treating yourself with gentle care is important too. Listen to your body - it's making up all the rules for the moment - craving fish?? - go for it. Why not. Good things within reason.

If gingersnap cookies work for you, great. Who knows, maybe gingersnap cookies work just as well as any other form of ginger, if one thinks ginger helps settle a stomache or quells nausea.  I've never tried ginger snap cookies to soothe an upset stomache. I've never tried Tig's ginger ale recipe either, but most folk I have heard of, have tried ginger in various forms, some, in the more raw, juiced, or more concentrated forms, rather than regular gingersnap cookies. My Mom used to just give us kids regular ole commercial gingerale. I remember my Granny giving us tablespoon sips of real "ginger beer", when we were little tykes and when us "little lambies were feelin' poorly" - that's how she used to say it (she hailed from North Carolina). Don't know if it was the ginger beer or just the doting loving care, but mostly our tummies got to feeling better. My Granny loved candied ginger, yuk. I like ginger best, and lots of it, sliced up in a nice sizzling hot wok of chinese chop suey! No so practical if I had a queasy stomache!!

I hope this coming week and every week after just keeps getting better and better for you, I can't wait to hear some of your next good news blood works to come!

Remind me again please, when are your next planned doc visits, and lab draws, through treatment? How many VL's and LFT's will you be getting and when?

Yay Bilbo, you're killlin' it!biggrin C.



-- Edited by Canuck on Thursday 18th of May 2017 12:46:22 AM

__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 64 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)
Bilbo626


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I'm No longer Ranting I am finally on the Harvoni Train. Time to slay a Dragon.
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http://hepcfriends.activeboard.com/t63209883/taking-a-class-before-starting-harvoni/?page=2&sort=newestFirst

I started here in February after I was getting the Run around by my Doctor.  Thanks to the support of the members here I just finished my first of 12 weeks on Harvoni. One week completed. Kind of like a rollercoaster of symptoms. Fatigue and boundless energy come in waves. Sometimes weakness most often is tenitus. Strange muscle and joints soreness. Yesterday I had a headache that would kill a cow. I have been avoiding otc pain killers because I heard some are processed by the liver. Ginger snaps for heartburn The best advice anyone has lots of water which is my constant companion. One person at work asked if I was dating my water bottle. I've also been having a lot of cravings for fish I'm not sure if that has anything to do with it. Thank you for all the wonderful advice you guys have been absolutely a godsend. As week 2 starts I'm looking forward to the side effects being more stable after my body gets used to Harvoni.          

 



-- Edited by Bilbo626 on Thursday 18th of May 2017 10:17:46 AM



__________________

Harvoni 12 weeks

51yo Cont 1983 by Blood Trans Diag 2003

viral load test 2.8mil

Geno type 1A

TB Test Neg

Eye and Retna Norm

Liver function test. F1

ultrasound of my liver F1
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