Hepatitis Forums
Hepatitis C Main Forums => Living with Hepatitis C => Topic started by: luckylarry on July 16, 2015, 09:47:46 pm
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I was diagnosed with hep c in 2003.At that time, I was in denial and just not ready to deal with the disease. After three biopsy's and the new medications out there, I am now ready to begin the fight.
My doctor is going to prescribe Harvoni to me after I complete my final Hep A and Hep B vaccinations on Sept. 17th. Unfortunately, he says that my liver is in relatively good condition as well as my blood counts. Does anyone have any advise for me to prepare for the denial process?
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Hi luckylarry, I have not been denied yet but my Dr.said she & her team handle appeals.Better check if your Dr. will do the paperwork.I wish you all the best ...we are all in this together so keep posting .We can keep learning & leaning on each other.
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Hi luckylarry,
I have been denied treatment twice once for Solvaldi and now for Harvoni. The problem is the cost. Solvaldi cost $84,000. That works out to be $1000. per pill. Harvoni is more expensive, around $1300. per pill. As it was expanded to me, since the medicine is so expensive insurance companies go by need. The worse shape your liver is in the better your chances of treatment. Your Doctor has to provide documentation for Cirrhosis and fibroid damage. It goes on a scale from F0 to F4, F4 being near the end of liver function. If your liver isn't to damaged your chances go down. As the spokeswomen for my insurance told me, if they gave the medicine to everyone they would go out of business.
Don't give up, there are ways to get the medicine. Get in contact with Gilead, the company that makes the medicine. They have a program called Support Path. Through them you may be eligible for the medicine at little or no cost to you. That is where you should start. In the mean time live as healthy as you can. Stop doing everything that further damages the liver like alcohol and drugs and certain over-the counter medicines.
Stay positive. Get as much information as you can. No one will work as hard as you to be cured. You are your best advocate, so get involved with your treatment. Don't rely on your doctor to do the right thing, get involved.
From personal experience, I have found this site to be great for support.
Best of Luck!
Rick
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Hey Larry! You are on the right track.No doesn't mean no exactly.I got denied because my bcbs did not cover name brand drugs..only generics of which there are none.my viral #'s were pretty low even though I have had HepC a very long time.My fibroscan numbers were F2\3.calling Gilead is a great thing to do right away.They start an investigation that helped me get approved.Your Dr.should do the appeal.Mine was great about that too. The Patient Advocate Foundation actually called my doctor & my insurance company which may be why I was approved even though I do not have coverage for Harvoni.The # is:800-532-5274....there are other foundations but if the insurance won't pay anything they will say you don't qualify.After your insurance company sends you another denial they should send you a letter that offers an outside review. The whole ordeal cost me about 2 weeks of despair but I'm getting Harvoni.I wasn't laying down & neither should you.The idea we have to be in serious health to be treated is obscene.Good luck & keep us posted on your progress! :-X
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I just received news from my Insurance that my appeal decision was in my favor and I will be receiving Harvoni. I believe that the decision would not have changed if I had waited for my Doctor to act. The main reason for my denial was that my new Doctor, who is a leading expert in HepC at the University of Buffalo, did not send any documentation of my current liver heath with the initial request. The way I see it, the medicine is sooo.. expensive, around $1300.00 per pill and the usual treatment is 12wks at 1 pill per day, (you can do the math), that only those who have stage 3/stage 4 liver health will get the medicine. The new doctor has not sent me for any new testing since I first saw his assistant back in March. I had to ask my previous doctor to send him my old test results. When he did that, things started to change So regardless on your Doctors expertise, you must take action to make sure all obstacles that stand in the way of your treatment are removed. Believe me, my work is not over yet. There are still time dates that need to be met to insure that the insurance company will continue pay for the medicine. The system is so screwed up that the nurse asked my if I had the prescription. She should have known that the physician must send to the supplier.
Words of wisdom, "never give up" you are worth it. Stay on your game.
Rick
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Congrats on your win with the insurance company, Rick! That's great that you will be receiving Harvoni. And good advice about being your own advocate and staying on your game. Even the most "expert" doctors cannot be counted on to negotiate the insurance nightmare for you.
Best of luck on your treatment,
kim
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I got my approval today for Harvoni. On the initial try, no less. I am really excited and
anxious to begin treatment and clear this nasty from my system. Will keep you posted.
Larry
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Congratulations luckylarry!
Looks like you picked a good nickname!
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Larry and Rick... it looks like both of you will be getting Harvoni! Right on...
I'm on the last week... and it has gone very well so go in with a positive expectation, I think that helps.
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Rick & Larry you made my day! It has only been a month since I felt just like you.Maybe we are seeing a change where patients get life saving medication without having to be so sick that positive outcomes are harder.If you go to your account you can put your stats in so when you get first lab results we can celebrate again.pulling for you all!
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Thank you all for your words of inspiration. I finally started treatment. Today is the seventh day. I haven't noticed any changes in how I feel. Taking each day as a new beginning. I feel strong and well! Let's hope we all can get out from under this heavy load and be free of the virus. That is my aspiration!
Rick
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Hi yag1064! Great feeling great again! I am mostly feeling great but when I rise theres a "hung over" feeling...till I remember I don't drink anymore & grab some water...it goes away quickly. Do you have the full 12 weeks tx?
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Great news Larry & Rick! Welcome to the club. Hope all goes well for the both of You & Godspeed. Check out the wonderful world of Hep info. here on the forums. In formative , enlightening, helpful , as well as humorous.
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Yes! Slats in charge of funny!
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LAUGHTER IS THE BEST MEDICINE , EXCEPT FOR TREATING DIARRHEA!!! Everybody been practicing their Happy Dance???? If all the Heppers around the world broke out into a spontaneous Happy Dance it would blow everyone elses mind.
But I bet there would not be to many people not dancing!!!!!!What do Ya'll think. A good ol' Texas hoe down!!!!
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I'm game, tommy! Let's do it!
kim
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O.K. EVERYBODY, ON THREE! A ONE ,AND A TWO ,AND A.........
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Meaning to ask Tommy if he keeps a book of brilliant quotes nearby or have you memorized the book?they are great !
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BYEBYEC ...you are rockin that virus ...super numbers!
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Tommy,
and a 1, 2, 3, 4 ! And, what's wrong with laughing with diarrhea, lol :D
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Why thank you mademoiselle Rosie! Very happy alt rebounded so quickly :) Every step's a victory.
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Rosie, a little of both. Love to read but the attention span is short. Therefore , shorter stuff inspired and occupied.
byebyec, I have heard of laughing unit peeing ones self. ( re.post on laughter general topics ) But laughing until one craps oneself just seems a lttle weird.LOL!!!
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So I have an older Lab/Border Collie mix that had been stricken with a spinal stroke 5-6 yrs ago that almost left her hind quarter paralyzed. She made a miraculous partial recovery. However, one of her permanent afflictions, has been the inability to squat for number two. Instead walks around wiggling to do her business and it is quite a spectacle, that my wife has referred to as a "happy dance". My point? The duel process described above is possible. I rest my case.
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So I have an older Lab/Border Collie mix that had been stricken with a spinal stroke 5-6 yrs ago that almost left her hind quarter paralyzed. She made a miraculous partial recovery. However, one of her permanent afflictions, has been the inability to squat for number two. Instead walks around wiggling to do her business and it is quite a spectacle, that my wife has referred to as a "happy dance". My point? The duel process described above is possible. I rest my case.
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Gives new meaning to "happy dance".nice recovery story BETO!
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At least I can say I did not start the potty humor :D
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Lol Beto! :D
Nearly ;D entirely Tommy's fault! Heehee ;D
Hey Tommy,
Is it painful under that bus I just threw you under?... ;p
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That darn Tommy
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WOW , Really guys ? I am shocked I must say!!!!!LOL!!
Let's see that makes Me an insane zombie jester with a propensity for potty humor!!!!!!Did I miss anything? I FEEL SO UNNECESARY!!!!
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bbc, Tire tracks all up & down My back , I can see You had Your fun!
Jimi Hendrix
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Haha Tommy!
I did! I DID! :D runs around gleefully with arms in the air! (in my mind of course) teehee 8) 8) 8) 8) 8)
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BBC , BTW from under here it looks like You need an oil change & a front end alignment. Glad it wasn't the TRAIN , right Perci?????????
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HEY! Literal low blow!!! OUCH! ;D
For some reason Perci is laughing maniacally... I just don't understand...
Ok, ok. I DO need an oil change & a front end alignment... ;D
Et tu Tommi???
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Marianne , Can't get much lower than under here LOL!!! After all I figured You were the one driving!!!!!!!
Is that laughing MANIC or MANIAC? Me personally , I could use a complete overhaul and an extended stay in the body shop for this old Fart!
Voulez Vous Loco en La Cabeza Cher? That's three dialects , I bet Gnatty will get a kick out of that statement!!!
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Oui oui Monsieur! Je suis loca en la cabeza! Evidemment! :P
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These posts should have Gnatty rolling around on the floor , should bring her out to play too!
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Luckylarry, just realized hijacking in progress. No criminal intent. How are You doing? Hope all is well with Tx. Hopefully the Sx. gods are being nice to You. Update us when You get time!!
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Day 15 of treatment. So far so good.
Just a couple of blah days, but I think a lot of that were
Sinus issues that I have. I sense a
Light at the end of the tunnel
Now I am looking forward to the 4 week
Blood work.
Peace
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luckylarry, Good news. Great to hear. Hope You are lucky all the way through Tx.
Update Your signature with Your lab results when You get them. It's always nice when people are on the easy side od Tx. Just finished My 12 weeks Tuesday. I was glad to see that the light wasn't another train about to run Me over!!!! Seems it was the Sun shining. Keep at it and stay in touch!
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LuckyLarry
Very exciting isn't it? It is like getting on the greatest ride of your life. For most, the sides are not bad at all and when you have them, it's like..."so what" I always looked at the sides as indication the meds are working and lots of viral die off. Enjoy the ride and the added benefit of Tommy's crack up remarks and banter.
good luck at week four
beto
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To luckylarry and all,
I just realized that there are many of us on this thread that are at the same spot in Tx (Maybe the fog is lifting). This is my 4th week. The really nice thing about this to me is that we all had our journey to get here. I know, for me this is my 3rd Tx. I smiled when I read my results. Viral Load:20.00. I can be happy for myself and others at the same time. That doesn't happen that often for me so it tastes really sweet. The bond is good. Let continue to walk this path. One step at a time..
Congratulations to all...
Rick
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Yep Rick and Larry,
I'm 4 1/2 weeks in too. Plenty of good and nutty company here!
Happy Heppers Salute you! :D
Marianne
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Hey Yag,
Cool is it not? Just like that VL 20. It likely took months for you on the Infrn/ribo to get it down a few K. Happy for you my friend...hang with this group and you will be OK.
peace
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Congrats Lucky Larry and Yag and ByebyeC, et al.! You are well on your way on a journey so worth while. I'm a week post treatment and just got an Undetected result. I'll hold the space for you and we can all bliss out together!!!