Hepatitis Forums

Hepatitis C Main Forums => Considering Hepatitis C Treatment => Topic started by: Endless77 on February 25, 2017, 07:37:46 pm

Title: UHC/OptumRx and harvoni??
Post by: Endless77 on February 25, 2017, 07:37:46 pm
I'm wondering if anyone has recently been approved by OptumRx (united healthcare's specialty pharmacy) for harvoni? I know they recently removed the fibrosis restriction from their pre-auth requirements, and was wondering if anyone without fibrosis had been approved? I contacted hcv in 2013. Late last year, I had an abdominal ultrasound (liver appeared normal)  and labs showing mostly normal liver function (AST was slightly elevated), with a viral load of 54,200. Going in for a fibroscan on Tuesday, then my GI will be submitting a pre-auth to United Healthcare.
I know I have a very low viral load and no obvious complications, so I'd like to hear from people who have gone through the approval process.

Also, my UHC plan is through work, not through Medicare or Medicaid (the state I live in contacts w/UHC for some government plans. I know these plans still have the fibrosis restriction). OptumRx manages my pharmacy benefits (some UHC plans use Express scripts).

I hope to hear from someone  :)
Title: Re: UHC/OptumRx and harvoni??
Post by: Lynn K on February 26, 2017, 11:27:56 pm
I do know many were approved by this healthy plan the only way to find out how it will work in your situation is to submit and wait you should hear fairly soon.

I wouldn't waste your energy on worry until you have something to worry about

Good luck!
Title: Re: UHC/OptumRx and harvoni??
Post by: Endless77 on March 29, 2017, 03:55:22 pm
So my GI Dr submitted my pre-auth this past Thursday, it's almost been a week and looks like it's still pending. I know these things take time, but the anxiety is crazy! I did call Optum, and they confirmed it had been received & they had everything needed, so it's pending at this point. I'll post an update when I get the decision. Hopefully it's approved and gives hope to others like me w/little-to-no fibrosis that we can still get these meds approved. We'll see!
Title: Re: UHC/OptumRx and harvoni??
Post by: Lynn K on March 30, 2017, 09:47:04 am
Good luck!
Title: Re: UHC/OptumRx and harvoni??
Post by: Endless77 on April 26, 2017, 09:16:37 pm
Endless77
From: Endless77
8:55 PM

So I wanted to let you all know, United healthcare approved 8 weeks of harvoni for me! So they really have removed the fibrosis requirement from their criteria! It should arrive from their specialty pharmacy next week!  ;D
Title: Re: UHC/OptumRx and harvoni??
Post by: Lynn K on April 26, 2017, 09:27:41 pm
Great news endless, congrats!