Big Changes in Gilead's Support Path for Harvoni

[Else]

In a letter dated July 1st, 2015, Gilead stated that it will no longer pay for medication for people who have been denied by their insurance.  "Specifically, patients who are insured and who do not meet their payer’s coverage criteria will no longer be eligible for support via Gilead’s Patient Assistance Program."

I called Support Path yesterday to verify what I had read.  Yes.  It is true.

They go on to state that "a very small number of patients fall into this category."  Really?  Lucky me.  I was one letter away from a full-packet, qualifying submission.  Anyway, I don't believe that it's a very small number of patients.

In any case, I can't afford the medication.  For a while there I felt lucky I was too sick to work.  The additional income would have put Support Path out of reach.  Now I'm feeling very unlucky that I have insurance.  If I was uninsured, I would still qualify and get medication.

This roller coaster really has me tapped out.  I'm starting to think I should work on not caring anymore.  It comes at too high a price with no ground gained.

[KimInTheForest]

WOW! That seems like pretty big news to me. And I agree with you Else - I do NOT believe that it is a very small number of patients who will be affected by this new policy of Gilead's. Judging by what so many patients posting on these forums have been going through, I think this new policy will negatively affect a great many people and their ability to get access to the drugs that will cure them.

kim

[HepKitty]

Else, I am so sorry to hear this. I am currently waiting for my insurance company to approve me for Solvadi and I understand the frustration and anxiety this process can cause. I thought that I would be eligible for Support Path now don't know what I will do if they refuse me except to try for a clinical trial somewhere. If you have not looked into that maybe you should as well you can search at: Clinicaltrials.gov

Also I would keep appealing with your insurance company. I am not sure if your doctor can use additional diagnoses to advocate on your behalf? You may need to emphasize the seriousness of your condition. Whatever you do don't give up hope. Keep trying and hopefully very soon these cures will be easily accessible to all of us. Good luck!

[Hillgill]

Yep been through failed treatments several times, waited on this treatment and now I have been denied through Express Scripts and Support Path. Lots of pain and anguish for nothing...

[lporterrn]

Sadly, this is true about Gilead. I agree - keep appealing. Also, try http://www.hepatitisc.pafcareline.org/ or Help-4-Hep  877‑Help‑4‑Hep (877‑435‑7443).

Fingers crossed that Merck comes through with a patient-friendly product.

[morning_glory]

In a letter dated July 1st, 2015, Gilead stated that it will no longer pay for medication for people who have been denied by their insurance.  "Specifically, patients who are insured and who do not meet their payer’s coverage criteria will no longer be eligible for support via Gilead’s Patient Assistance Program."

I called Support Path yesterday to verify what I had read.  Yes.  It is true.

They go on to state that "a very small number of patients fall into this category."  Really?  Lucky me.  I was one letter away from a full-packet, qualifying submission.  Anyway, I don't believe that it's a very small number of patients.

In any case, I can't afford the medication.  For a while there I felt lucky I was too sick to work.  The additional income would have put Support Path out of reach.  Now I'm feeling very unlucky that I have insurance.  If I was uninsured, I would still qualify and get medication.

This roller coaster really has me tapped out.  I'm starting to think I should work on not caring anymore.  It comes at too high a price with no ground gained.

  I am in shock & very upset by reading this... but before I overreact... is there a link to this letter/info?

Thank you & Blessings,
MG

[Else]

I don't know how to attach a .pdf file to this message board so here's how a 'copy and paste' version looks.  The only  thing missing is the letterhead.  Apparently it was posted on a HCV advocacy site on Facebook by an Andrew Reynolds.  I believe the site is Hepatitis C Family and Friends.  It is a closed group.  I don't have an FB account so I couldn't ask to join if I wanted to.

It's been driving me nuts that I can't find a link or reference to it, independently, on the internet, though it could be my crappy tech skills.

But I did call Support Path and they verified the contents of the letter.  I don't even know who the letter was sent to.  "Dear Community Partners" - whoever they may be.

I've been in contact with Support Path (with a patient reference #) since late March.  They have ALL my contact information. You'd think they would have contacted me rather than let me carry on with a patient assistance intake packet that was now ineligible.  How many weeks or even months would I have waited to find out what is clearly stated in this letter dated July 1st???

"Wednesday, July 1, 2015
Dear Community Partner,
Gilead has always been an advocate for patient access to therapies in the areas in which we work. I am writing to provide you with an update regarding Support Path, our patient support program for individuals living with chronic hepatitis C.
As you may be aware, Support Path is designed to help patients in the U.S. with high co- pays or who lack adequate insurance access Sovaldi or Harvoni. The Support Path program provides assistance to patients who are uninsured or who need financial assistance to pay for the medicine.
Key components of the program include:
In the interest of facilitating patient access in the period immediately following the launch of Sovaldi and Harvoni, the Gilead Patient Assistance Program (PAP) made these medications available to virtually all patients who met financial and other program requirements. Gilead also implemented significant discounts for its HCV therapies across different payer groups. While many payers responded to these discounts by opening access broadly, some payers have continued to restrict access despite the discounts.
As a result, our PAP criteria enabled continued restrictions by some payers by providing a generous route for them to deny access and refer patients they have chosen not to cover. While we have approved many of these patients in the past, we feel it is necessary to establish more specific guidelines for patient eligibility. Our PAP was designed to help uninsured patients with the most need, and changes are necessary to remain true to that mission. We believe these changes also will help increase access among those payers who continue to restrict access.
With that in mind, effective July 1, 2015, the following changes will be implemented. Gilead anticipates these changes will not impact the majority of patients helped by our patient support programs.
Specifically, patients who are insured and who do not meet their payer’s coverage criteria will no longer be eligible for support via Gilead’s Patient Assistance Program. Patients who fall within the category of “Insured and Did Not Meet Payer Criteria” are patients whose insurance providers limit access to Sovaldi/Harvoni based on, but not limited to, the following:
 Fibrosis score restrictions
 Preferring or exclusively covering another product on formulary (i.e., Viekira Pak preferred)
 Limiting coverage to a maximum treatment duration or denying subsequent treatment after a
patient has failed therapy
 Step-therapy requirements
 Clinical criteria (e.g., psychiatric requirements, drug and alcohol testing)
It is important to note that a very small number of patients fall into this category. Support Path experts will continue to treat each patient case individually and consider a number of variables when assessing patients for our free drug program.
 The Sovaldi and Harvoni Co-pay Coupon Program, which minimizes monthly out-of-pocket costs for eligible patients* to as little as $5 per month
 The Support Path Patient Assistance Program, which will provide Sovaldi or Harvoni at no charge for eligible patients
*You are not eligible if you are enrolled in a government healthcare prescription drug program such as Medicaid or Medicare
Part D
For Sovaldi and Harvoni patients who are insured and have been denied coverage by their payer, Support Path can assist patients with the requirements for submitting appeals, peer reviews and understanding the process for in-person hearings if required.
Gilead continues to support open access to hepatitis C therapies – with prescribing decisions made by a physician in partnership with his or her patient. We will continue to work with payers to provide information that conveys the profile of our hepatitis C medications and the benefit of curing individuals living with the virus. We believe that payers should take the responsibility to provide coverage for their insured patients based on the treatment decisions of their healthcare providers.
Through Gilead’s Support Path Program, which provides a comprehensive suite of patient assistance resources, we are committed to our mission of helping patients in financial need access our products, and to ensuring our patient assistance program reaches eligible uninsured patients.
As always, we appreciate the ongoing dialogue with our community partners and look forward to continuing to collaborate with you on efforts to expand access to life-saving therapies.
Best regards,
Coy Stout
Vice President, Managed Markets Gilead Sciences, Inc."

[Hillgill]

I was denied by Support Path just this week due to these reasons.  They did offer to assist with an appeal to my insurance company though. Again we wait.

[Lynn K]

Andrew is a community partner. I believe they are patient care advocates working in our behalf

[morning_glory]

Else,
Thank you for posting the letter.

I am hoping and praying for those who had started the process of getting HCV medication through Support Path - Praying they may be "grandfathered-in", before this decision was made by Gilead.

Blessings & Prayers for those needing a cure,
MG

[sapphire101]

Thank you Else for posting this information.
I have read and reread the letter to Community Partners and I cannot figure out just who exactly is the Support Path going to assist now.

They will no longer assist people who have insurance, but did not meet payer criteria which is probably half of the patient volume. They wont help anyone on Medicare which is everyone over 64 and a big piece of the baby boomer cohort group likely to have HCV. They wont assist Medicaid which is largely made up of our citizens on a low income.

Who is left to help?

[sapphire101]

I do agree with Gilead's statement that their generosity may have enabled insurance companies to continue restrictions and to deny access and refer patients that they chose not to cover.
This cutback on patient assistance from Gillead may be a way to force the hand of the payers and ultimately widen the access for all.

Still very frustrating for all of those needing the medications.

[Else]

I do agree with Gilead's statement that their generosity may have enabled insurance companies to continue restrictions and to deny access and refer patients that they chose not to cover.
This cutback on patient assistance from Gillead may be a way to force the hand of the payers and ultimately widen the access for all.

Still very frustrating for all of those needing the medications.

I can't use "generosity" and "Gilead" in the same sentence with a straight face. 

Think of the timing of their U.S. television media blitz.  April 18th or thereabouts.  I've also recently received hefty mailed advertisements.

So April 18th for T.V.  Average time to get in to see a doctor may vary.  My hepatologist's handout estimated 6 to 8 weeks for prior authorization and insurance approval.  Along with the assurance that if insurance denies twice, there is always Support Path.

I do not believe the timing of the media rollout and the July 1st policy change was an accident.  Do those commercials look like they're geared towards an uninsured population group?  Nope.  They're targeting middle America.  Who get to find out, in the bottom of the 9th inning, after months of fears and stress and hope that they will not receive treatment because they have insurance.

Manufactured outrage.  And outrage not at them but at the insurance companies.  Very clever.  Price-gouging is no longer the focal point. 

Big Pharma is evil, plain and simple.  Maximizing profit is the core tenet of every policy they make.

[KimInTheForest]

Very astute assessment, Else. I am inclined to agree.

kim

[lporterrn]

I'd like to add to Else's comments that medical providers are averaging 8 hours of unpaid time spent on each patient trying to secure approval. Doctors are pulling their hair out.

[Else]

I'd like to add to Else's comments that medical providers are averaging 8 hours of unpaid time spent on each patient trying to secure approval. Doctors are pulling their hair out.

Unpaid time?  I think that's a really unhealthy way for medical providers to view the situation and really detrimental to doctor/patient relationships.  It's bound to breed resentment on both sides.

As a highly trained professional, I would eventually resent patients that took 8 hours of my labor without paying.  As a patient with full insurance who also pays their bill in full and in a timely manner, I would resent the implication that I was mooching free services.

Lose/lose perspective.

It's not really unpaid time.  The insurance companies are arbitrarily altering the contracts they have entered into with medical providers and that is wrong.  Providers waiting an average of 8 weeks to get compensated for their labor is also wrong.  But it's still a contractual agreement that the medical providers have entered into so they can have "preferred provider" or "in network" status.  And that agreement guarantees a flow of patients through their doors.  (They could elect not to accept insurance and to require patients to pay up front and file their own claims.  They would lose those patients.  If they could keep their doors open at all, it would be a very small practice.)

In exchange for access to a large patient base, the provider agrees to network discounts applied to their rates or a ceiling rate for any particular service.  They also agree to submit claims on behalf of their patients and pay for all the clerical support that facilitates this process.  Increasingly, every year, insurance companies foist more and more of their administrative duties onto the doctor's office staff.  The labyrinth of obtaining PA's is just more of the same.  A lot more.  But it is a contractual agreement they're entered into voluntarily and they are, in fact, getting paid.  They've struck a poor bargain.  There's a difference.  Words are important. 

Look how Gilead finesses their press releases.  They don't want to be "enablers".  They've been so "generous".  You'd think they ran non-profit orphanages.  It seems that both large insurance companies and Big Pharma encourage an adversarial relationship between patient and doctor.  It serves them both well.

[lporterrn]

Actually, most don't resent it. They are as pissed off as their patients because they see that this blocked access to medication wrong. And yes, it really is unpaid time. You can only get reimbursed for direct patient services.

Personally, I have never worked with a doctor who would turn their back on a patient. I know there are some uncaring ones, but I have been fortunate in working with amazing human beings - some, like myself, give our time away. I do it because I want to - not because I have to.

Don't take my word for it - go to this site and click on the webinar and listen to Dr. Trookin http://nvhr.org/content/webinar-strategies-hepatitis-c-treatment-access She freely gave her time for this.

I spent an entire day lobbying in Sacramento with others in healthcare. One flew from San Diego - his flight was paid, but his time was not. He flew in for the day. We did it because we want this nonsense to stop. He gave up a day of work, figuring it would pay off for his patients. The good news is, the legislature approved more than we requested.

I spent 3 days in D.C. the same month - again with other advocates, some in healthcare. We were not paid. We lost this one. We will try again next year.

We could use some help - hope you will join us in this fight. NVHR is one place to find out what you can do.

[Else]

I didn't mean to imply that all doctors resent their patients or are uncaring.  There IS an undue amount of bureaucratic b.s dumped on doctors that has little to do with direct patient services.  And it gets in the way of their ability to help their patients.  I don't doubt for a second that most if not all are pissed off.

I have nothing but respect and admiration for those that give so selflessly of their time and efforts in patient advocacy, both on the politic front and support services.  That is unpaid time, but maybe pays richly in knowing one is trying to make the world a better place.

I appreciate the work you've done and will definitely look into the NVHR to see what I can do to help.

[Mike]

Hi Else,

While you certainly have a right to your opinion, I don't agree with your assessment of medical providers.

Specifically:

"..it is a contractual agreement they're entered into voluntarily and they are, in fact, getting paid.  They've struck a poor bargain.  There's a difference.  Words are important."

To be frank, when was the last time you went to work and said, "Gee, I'm not going to punch in today. I think I'm just going to work all day for free." ?

I'll wager you have never said or done that.

Mike

[Else]

To be frank, when was the last time you went to work and said, "Gee, I'm not going to punch in today. I think I'm just going to work all day for free." ?

I'll wager you have never said or done that.

Mike

You'd lose that wager.  Have you ever worked in sales?  Or been a small business owner?  I've worked all day for free more times than I can count.

But the tone of my post was harsh and judgmental.  I regret that.  I'd hoped I'd made it clear that doctors in private practice are getting royally worked over by insurance companies.  Delayed or denied reimbursements and a financially burdensome amount of clerical work required to do business.

But they don't punch in; they're not paid an hourly wage.  They're either salaried employees or small business owners paid per service.  And when your hours go up and your compensation doesn't, it sucks.

I'm sure doctors DO resent insurances companies rather than the patient.  But medical providers are human beings.  It would get under anybody's skin to be thinking, "I'm working on behalf of this person for free."  It just not a healthy mindset, IMHO.

[Mike]

I have never worked in sales, which is an occupation that is generally remunerated by commission (or performance goals). A  salaried employee gets paid regardless of going the additional mile.

A  salaried physician gets paid to see patients. They are doctors - not billers, coders or support staff.

Doctors are well verse in dealing with insurance companies - especially doctors who work in private practice (a dying breed I might add). Insurance denials (pre-certifications for treatment) are part of the everyday job.   

Knowing this, I fail to see why a doctor would resent a patient because the physician  had to deal with an insurance company denial. This is an everyday occurance (denials) and happens across the disease spectrum.

Mike

[Else]

Geez, Mike.  I just posted

I'm sure doctors DO resent insurances companies rather than the patient.

  And they do.  I think it was posted earlier that they're tearing their hair out?

What's with the "I fail to see why a doctor would resent a patient"?

People do not appreciate working for free was my point.  If that's their perspective. 

I'm not doctor-bashing here.

[KimInTheForest]

I agree totally with your comments on all of this Else.

And Mike, if you truly cannot see why a doctor would (wrongly) end up resenting and possibly even expressing that resentment to the patient over this situation with insurance companies and the considerable extra work it creates for doctors, then you must have been very fortunate to have had nothing but very compassionate and selfless doctors throughout your entire life. Few of us have been that lucky. And as you can see from scanning these forums, a great many users are reporting horrendous experiences with doctors who resent them if they merely ask for their lab results. Doctors frequently direct their impatience, frustration and resentment at the easiest and weakest and most disempowered party in all this, which if (of course) the patient - not an insurance corporation.

You have nailed it, Else. Good for you for doing so. Thank you. Helps many here.

Best,
Kim

[Philadelphia]

I must look at salaries a little differently. As a professional in a managerial role I am paid a salary. I'm not paid by the hour. My job takes as long as it takes. I have minimum hours but no maximum because there are times when I might need to go to training, meetings, work on weekends, attend to phone calls "after hours" and manage employees, manage the work place, liaise with contractors etc among a plethora of other activities.

I always thought of doctors as being in a similar position to me.

[Mike]

Kimintheforest,

No. I can't say I have ever met a doctor that resented his/her patients due to an insurance denial. In fact, I work in a profession were insurance denials are common and have interacted with 100's of doctors over the past 20 years.

I've never seen this expressed by a single physician nor have I met a patient with this sentiment/experience.

I must be lucky and have some lucky clients.

Mike

[lporterrn]

I'm with Mike on this one. I have seen plenty of resentment aimed towards the insurance and pharmaceutical companies, but not towards patients.

[Else]

No. I can't say I have ever met a doctor that resented his/her patients due to an insurance denial. In fact, I work in a profession were insurance denials are common and have interacted with 100's of doctors over the past 20 years.

I've never seen this expressed by a single physician nor have I met a patient with this sentiment/experience.

I must be lucky and have some lucky clients.

Mike

And you probably never will.  What doctor, while in a business environment, would openly say, "I resent the extra workload that comes with providing services to this patient."  It'll never happen.  Doctors are professionals.

And what patient would say in that same business environment, "Gee, my doctor seems apathetic, inattentive and unable to keep up with his/her workload."  You won't ever hear that either.  Not there.  Patients are utterly dependent on the goodwill of their doctor - they wouldn't dare.  But you hear it HERE.  Anonymously and regularly.

My point wasn't about taking sides.  Nor was it to doctor-bash.  How would you like to go to medical school for 8 years, likely rack up enormous debt, pay exorbitant malpractice insurance only to find yourself in position where you can't provide the quality medical care you trained so hard to do?  It would be infuriating and demoralizing.  And to add injury to insult, their perception is that they're having to do work that they are not compensated for.

You can't address a problem if you refuse to acknowledge it even exists.  The problem is that we do not have a Health Care System.  We have a Health Care Industry.  That's an important distinction.  And in any service-based industry where the employees are frustrated, under-compensated and disrespected (for example, when doctor's medical decision-making powers are usurped by the insurance companies), the quality of service tanks.  And, right or wrong, the dissatisfaction is almost always taken out on the consumer.

To add fuel to the fire, if a patient expresses frustration in a lack of communication or timely services, what's a very human doctor going to think?  "This person is not only costing me money (unpaid time!) they're ungrateful to boot."  I think it's terribly unfair to expect doctors to be saints, crusaders or selfless workers.  They're just people.

[Mike]

The clients I work with have no problem speaking out against a doctor - no problem whatsoever. In fact, I have helped many change to another physician for various reasons.

However, this was never due to a doctor resenting a client due to paperwork or an insurance denial.

To address this:

"...if a patient expresses frustration in a lack of communication or timely services, what's a very human doctor going to think?  'This person is not only costing me money (unpaid time!) they're ungrateful to boot." 

Have you ever thought that the doctor might not like the patient's attitude? Or the doctor might resent an 'unjust' accusation? Is there is such things an over-demanding patient with unrealistic expectations?

Have you ever heard of a self fulfilling prophesy?  Paradoxical distortion or other intrapersonal  dynamic other than money?

I have a hard time using a board-brush to paint an entire group of professionals.

Are there bad doctors? Sure. But that is the exception not the rule.

Mike

[lporterrn]

Yes, they are just people. And one thing that bothers me is that we tend to paint our opinions by how we think, rather than on evidence. There isn't one-size-fits-all definition of "people."

I worked and socialized with my colleagues. I feel sure about my opinions becuase I can back it up with nearly 20 years of field work. In general, the doctors I worked with didn't even come close to your assessment of them. Sounds like you have had some awful experiences. Sure wish I could send you some of my favorite docs Else.

[Else]

I really am mystified why you both are so invested in interpreting my posts as generalized doctor-bashing.  Of course there's no one-size-fits-all definition of people or professional groups.  Of course not. 

Yet it's as if I've said nothing else.  Very strange. 

[Mike]

Else,

You start a post with "I'm not doctor-bashing", followed by bashing doctors and the entire medical system.

For example:

"The problem is that we do not have a Health Care System.  We have a Health Care Industry.  That's an important distinction.  And in any service-based industry where the employees are frustrated, under-compensated and disrespected (for example, when doctor's medical decision-making powers are usurped by the insurance companies), the quality of service tanks."

Or:

"Doctors frequently direct their impatience, frustration and resentment at the easiest and weakest and most disempowered party in all this, which if [sic] (of course) the patient - not an insurance corporation."

Just saying

Mike 

[Else]

Mike,

Yes!  I was bashing the entire medical system.  Absolutely.  It does not serve the best interest of doctors nor patients in its current state.  It's a for-profit industry that serves the financial interests of insurance and pharmaceutical companies. 

And the second quote wasn't me.  It was someone who agreed with my line of reasoning.

I don't think I've mentioned that I've had the same family doctor for eleven years and have nothing but admiration for her.  I am extremely grateful to have this intelligent, highly competent woman as the GP for myself and my family.

So really?  I'm the last person who would lump ALL doctors into one group.

[Lynn K]

From the Wall Street Journal

Gilead Limits Enrollment in its Hep C Patient Program to Pressure Insurers

http://blogs.wsj.com/pharmalot/2015/07/16/gilead-limits-enrollment-in-its-hep-c-patient-program-to-pressure-insurers/

[S.Belle]

I have read all of the posts in this part of the forum and I must say I am blessed to have a gastroenterologist who put me in touch with Quality Specialty Pharmacy in Tampa. They helped me put together all of the information needed to petition Gilead for financial assistance. I'm on Medicare, but have NO prescription plan and single.

The petition included my tax return, pay stubs for this year (no, I can't afford to live on just Medicare. I will probably work the rest of my life.), a list of my expenses, my Hep-C stats and a cover letter telling them about me and my life. I agreed to give them access to my medical records and progress.

Thrilled to say I was approved and started Harvoni on July 14, 2015.  My financial status will be monitored also. Which means, I can't take a second job, even though I could use the money.

Don't give up and by all means, look for any avenue possible.

[Else]

Great news, Belle!  Glad you posted and glad that Gilead's Support Path is still helping people.  It's a narrower path than it was, but it's there!  Good luck with your treatment.

[S.Belle]

Thanks !  I'm on Day 7 and so far, so good. I take it after work and am ready for bed by 10. Mild headache at times and some light ringing in my ears. But if it works, it's totally worth it.

[w_ink]

Just found this thread. That's unfortunate news about Gilead's Support Path. I was going to turn there after Blue Shield CA denied coverage of Harvoni and Viekira Pak, when I lucked into a voucher from my doctor for free medication from AbbVie. So if you have genotype 1, Viekira Pak is another option. There are more pills, and for patients who take it with ribavirin, a few more side effects, but it's totally doable and there are quite a few Viekirians in the forums who are encouraging and supportive and have had great results with the V-Pak. I'm not that familiar with how the program works, but here are links:

https://www.pparx.org/prescription_assistance_programs/abbvie_viekira_pak_patient_assistance

https://www.viekira.com/proceed-support

[tracylee56]

 I JUST RECIEVED INFORMATION THAT I HAVE BEEN APPROVED BY MY INSURANCE THAT MY CO PAY WILL 120. A MONTH AND BEING THAT I CANNOT AFFORD THIS I WAS RELOCATED TO THE COMPANY THAT HELPS WITH PAYMENT OPTIIONS.  THEY HAVE A COUPON THAT I SUBMITTED ONLINE AND RECIEVED THE INFORMATION THAT MY CO PAY WILL BE 5-15.00 A MONTH. THERE IS HELP OUT THERE. PLEASE DO NOT GIVE UP JUST GO TO THE HARVONI WEBSITE SITE. I RECIEVED MY MEDICATION THIS MORNING AND WILL START TAKING THIS AUGUST 10TH. I HAVE HAD THIS DIEASE FOR 27 YRS AND HAVE GONE THROUGH 3 DIFFERENT TREATMENTS.

[KimInTheForest]

Congrats Tracy Lee on persevering and getting your drugs. And welcome to the forums and the Harvoni journey.

best,
kim

[slats1056]

   Man, I really don't know where to start after reading this. I guess start out by thanking my lucky stars for My Gastro & his staff as well as bcbstx ins., and southside specialty pharmacy here in Texas! After all Hospital, outpatient,labs,office visits & bills over a three month period it took less than a week from recommendation to approval to having My first Rx. in hand. Don't get Me wrong I wiped out my HSA account, met my deductible and out of pocket expense in that three month period. Not to mention work missed(straight commission sales), vacation days used & stressing about all of the above. No work by me at all to actually get the Harvoni. I just wish it was this easy for everyone & I feel really bad for those getting screwed. This should not be at all about big business but HEALTH CARE!!!!! My copay is $5.00 per Rx. Just got word last thursday that My out of pocket expenses have been met for this year.                                                                                                                      Does anyone have a contact for a legitimate organization for donations to help the folks that really need it? I am not rich by any means, but I truly think the Dragon can be slain with a little help. I DO NOT WISH THIS ON ANYONE. The stress involved is enough as it is.