Hepatitis Forums
Hepatitis C Main Forums => Considering Hepatitis C Treatment => Topic started by: Else on March 25, 2015, 11:27:15 am
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I've been looking at my insurance pharmacy benefits online. Very strange classifications.
Harvoni is NP (non-preferred, requiring medical necessity) PA (prior authorization), and SP (specialty pharmacy).
Vierka Pak is the same - NP, PA, SP
However Solvaldi is PA only. Really? Not even specialty pharmacy? And since Harvoni has the least side-effects and highest cure rate - isn't it already sofosbuvir but with ledipasvir. If ribavirin is added to a Solvaldi regime instead, it would push the price past Harvoni.
And regarding the best clinical outcome, surely the insurance company would realize that not requiring a second course of treatment would be in their financial best interest.
These numbers aren't making sense to me. I'm over 6 weeks away from my intake appointment with a new liver doc but I want to have that first meeting be as productive as possible.
My experience being the caregiver for my best friend who had cancer was that, despite brilliant doctors and "state of the art" treatment facilities, common sense could be overlooked with stunning regularity. That's where an advocate comes in so I want to be well-prepared.
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Sovaldi by itself is not prescribed for the treatment of anything. However, when prescribed with Interferon, Olysio and/or Ribavirin, it would require the same approval process as Harvoni or Vieka.
Best wishes, Mike
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If it's always part of a cocktail, then incomplete coding would make sense (in an unnecessarily vague sort of way.)
So I guess I'll find out which medications they prefer when I try to fill a prescription? Harvoni and Viekira Pak are listed very specifically as "non-preferred".
Insurance company's Rx information page not so informative. :-\
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Else, those lawyers have to get paid for something, even if it's fuzzy math and fuzzy
Cocktails! Lol
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Ha! Too true, Bubba.
Reminds me of a bumpersticker I saw once - Eschew Obfuscation
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Yep ;)