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Author Topic: How do I purchase Harvoni at lowest price available?  (Read 41739 times)

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Offline slw304

  • Member
  • Posts: 25
How do I purchase Harvoni at lowest price available?
« on: March 11, 2015, 01:19:32 pm »
United Healthcare not approving Harvoni.  They say "not medically necessary".  Gilead Patient Assistance program won't help either because we are over the income level for assistance. I am now being forced to cash in IRA to pay for 8 weeks of treatment.  Does anyone have experience with purchasing Harvoni from Canadian pharmacy online or can anyone offer thoughts on how to get a discounted prescription beyond the co-pay coupon which will apply to first month only?

Offline SIXFOOTFOUR

  • Member
  • Posts: 89
Re: How do I purchase Harvoni at lowest price available?
« Reply #1 on: March 11, 2015, 03:12:49 pm »
I have no suggestions on how or where to buy it a reduced price full cost is crazy expensive at about 1100 a pill $ 90,000 for 12 weeks.

I had to deal with a run around to get harvoni approved under my insurance, they contract with Express Scripts and Express Scripts made a deal with Viekira Pak to use them as Hep C medication due to a discounted pricing. But my doctor and medical group fought to get me approved for Harvoni due to the ease of use, less requirements for labs during tx and less side effects.

Before you decide to payout of pocket for it, id be sure that you have exhausted the appeals process and meet the requirements for treatment. In my case the VL of > 6 mil and stage 3 fibrosis was enough to push them into approval, but it took 90 days, 2 rejections and a offer to approve Viekira instead of Harvoni.

My doc did a few extra tests because the VL, blood work and biopsy were not enough, I had to also get the Fibro Test and then received the approval.

I guess Im saying be sure that you have a doctor that is willing to fight to get you approved
Sixfootfour
* Contracted Hep C 1971 post transfusion (non A - non
   B Hep dx in 1971)
* Dx as Hep C early 2000
* Geno 1b
* Stage 3-4 Fibrosis by Biopsy and FibroScan
* VL at start of TX > 6 mil
* ALT/AST High normal range at start of Tx 
* Started Harvoni 12 week course 3/6/15 -
   completion 5/29/15
* Undetected at 6 weeks on Tx
* ALT/AST Mid normal range at 6 week blood test
* Completed 12 weeks (84 pills) 6/28/15
* Undetected at 11 weeks & 6 months EOT

Offline slw304

  • Member
  • Posts: 25
Re: How do I purchase Harvoni at lowest price available?
« Reply #2 on: March 11, 2015, 06:58:37 pm »
Thanks sixfootfour.  I have received 2 denials from United Health Care and appealed to NC Dept of Insurance who upheld UHC's decisions.  My biopsy came back F1 and UHC is only approving F3 or greater.  Letter actually said to check back in a few years when I get worse.  It sounds like only the sickest patients are being approved.  Fortunately, my doctor says 8 weeks of treatment.  Gilead says I can use co-pay coupon which will cover a large portion of the first month.  That will leave me completely out of pocket for the second month, but worth it to be able to move forward in life and put this chapter behind me.  I will just have to work harder at my job over the next several years to make up for the loss.  I would still like input from anyone who has information regarding possible options to purchase Harvoni at a reduced price. 

Offline MEG

  • Member
  • Posts: 304
Re: How do I purchase Harvoni at lowest price available?
« Reply #3 on: March 11, 2015, 08:31:29 pm »
Slw...I'm so sorry that you were denied Harvoni...2 thoughts: I'm wondering if you can wait until later this year? There are important liver/hepC meetings coming up and the data presented might impact the guidelines and United Health Care may have to comply with your physician's order?

2) Gilead is working hard to make deals with all these insurance companies and who knows, things can change at United Health Care?

Add: Canada is a great idea if you want to pursue this asap, I'd check Europe too. I thought I read that they'd negotiated substantially lower prices for Harvoni.

Good luck....as a society we need to let physicians direct care!
« Last Edit: March 11, 2015, 08:40:40 pm by MEG »
Geno 1a. IL28B+ with TT polymorphism.
Diagnosed 1993.
Liver Biopsy 1993 --inflammation.
Fibroscan 2014---no fibrosis.
ALT range---60s
AST range---80s.
Platelets: 200K range.
Viral load--2 million range.

Began Harvoni on January 23.
Finished 12 week course on April 19.

May 18---4 week EOT labs:
VL: UNDETECTED.
AST: 23
ALT: 22...........These have not been this low throughout treatment and since my 20s.

12 weeks EOT on July 15---Undetected.

Offline slw304

  • Member
  • Posts: 25
Re: How do I purchase Harvoni at lowest price available?
« Reply #4 on: March 11, 2015, 10:15:54 pm »
Both good points, Meg.  I'm sure changes regarding insurance requirements will happen in the future but I'm not holding my breath that it will happen anytime soon.  I don't believe the healthiest patients based on lab results will be offered treatment until the drug prices drop.  As more treatment options become available the manufacturers will be forced to adjust pricing, however, I'm not certain that will happen until some time next year.  What I do know is that I don't want to live with my symptoms for that amount of time.  I would rather bite the financial bullet and focus on living my life and rebuilding my finances vs. waiting around on these companies to make the decisions that are out of my control.  After all, these companies have made it clear care more about their billions of dollars than they do my health. 

Offline MEG

  • Member
  • Posts: 304
Re: How do I purchase Harvoni at lowest price available?
« Reply #5 on: March 11, 2015, 11:18:10 pm »
@slw

I think it depends on the insurance company and importantly which pharmacy they contract with....I'm BC/BS. I have VL<2million, decent LFT's and no fibrosis and to my surprise(doc and staff too), I was approved for 8weeks. Because I'm 1a---once I began treatment, I pushed my doc to ask for 12 weeks and they did approve it with no problems.

What genotype are you? What are your viral loads. and LFT's? Do you know if you have the IL28B mutation and which subtype you have?

I ask because if you're 1a---I'd worry about 8 weeks. I also have the IL28B/TT allele and when I looked deeper into the clinical trials---those of us with this profile(even with low viral loads) were the ones that relapsed on 8 weeks and a smaller percentage on the 12 weeks.  Geno 1b's do much better, however.

These are the AASLD guidelines for treatment.

http://www.hcvguidelines.org/full-report/initial-treatment-hcv-infection

It begins with 1a and around mid-way down the page you'll see this at the end of their discussion re: Harvoni.  Post hoc analyses in a study are always problematic re: making generalizations to the broader population.  I don't know your background and apologize if you already know this.

""Post hoc analyses of the 2 RBV-free arms assessed baseline predictors of relapse and identified lower relapse rates in patients receiving 8 weeks of ledipasvir/sofosbuvir who had baseline HCV RNA levels below 6 million IU/mL (2%; 2 of 123), and was the same for patients with similar baseline HCV RNA levels who received 12 weeks (2%; 2 of 131). This analysis was not controlled and thus substantially limits the generalizability of this approach to clinical practice. Shortening treatment to less than 12 weeks should be done with caution and performed at the discretion of the practitioner.""""
« Last Edit: March 11, 2015, 11:21:37 pm by MEG »
Geno 1a. IL28B+ with TT polymorphism.
Diagnosed 1993.
Liver Biopsy 1993 --inflammation.
Fibroscan 2014---no fibrosis.
ALT range---60s
AST range---80s.
Platelets: 200K range.
Viral load--2 million range.

Began Harvoni on January 23.
Finished 12 week course on April 19.

May 18---4 week EOT labs:
VL: UNDETECTED.
AST: 23
ALT: 22...........These have not been this low throughout treatment and since my 20s.

12 weeks EOT on July 15---Undetected.

Offline sapphire101

  • Member
  • Posts: 238
  • "Stop worrying and start living"
Re: How do I purchase Harvoni at lowest price available?
« Reply #6 on: March 11, 2015, 11:50:27 pm »
I am waiting for the news that third world 'boutique' health care is picking up on the HCV population base and will start offering full workups, meds, and follow up.
Much like the hip replacements in Mexico and plastic surgeries in India.


This makes sense if you are going to go down the self pay path to get the most for your money. It would feel really good to be in control of your health choices and receive quality customer service.


Hang in there slw304.
This will work out and you will find your way and get your meds.
I too was very close to cashing in my savings to fund my treatment until I learned from this forum that Anthem/express scripts had approved Viekira pak for all levels of fibrosis and I was able to advocate for myself to get my treatment started.
Sapphire101
Genotype 1a Fibrosis level 1
Viekira Pak with ribavirin 12 weeks
Pre treatment  VL  1.7 million, AST 45 ALT 65
EOT VL not detected, AST 21 ALT 21
12 week SVR not detected,24 week SVR not detected.
Cured! Class of 2015

Offline MEG

  • Member
  • Posts: 304
Re: How do I purchase Harvoni at lowest price available?
« Reply #7 on: March 12, 2015, 12:41:38 am »
Sapphire, India has already approved a Sovaldi generic. They would not grant Gilead the patents.  $300/course of therapy. Problem is that it can't be taken alone. It needs either Olysio or interferon.  I'm sure they're working on Olysio and Harvoni too.

When I heard that it only costs Gilead a few hundred dollars to manufacture a course of therapy, my eyebrows furrowed and eyeballs rolled. On one hand grateful they commercialized this life-saver and otoh, angry that they charge these prices...
Geno 1a. IL28B+ with TT polymorphism.
Diagnosed 1993.
Liver Biopsy 1993 --inflammation.
Fibroscan 2014---no fibrosis.
ALT range---60s
AST range---80s.
Platelets: 200K range.
Viral load--2 million range.

Began Harvoni on January 23.
Finished 12 week course on April 19.

May 18---4 week EOT labs:
VL: UNDETECTED.
AST: 23
ALT: 22...........These have not been this low throughout treatment and since my 20s.

12 weeks EOT on July 15---Undetected.

Offline slw304

  • Member
  • Posts: 25
Re: How do I purchase Harvoni at lowest price available?
« Reply #8 on: March 12, 2015, 02:13:52 pm »
I am genotype 1a viral load < 1 mil.  I don't know about subtype or those other questions but will stay positive that 8 weeks is my cure.  I won't be attempting to pay for 12 weeks.  As far as treatment approval from United Healthcare, they have slammed every door I have attempted to open.  They have happily collected over 12 years of insurance premiums for a family of 4 but quickly deny healthcare outside of the routine stuff.  Their own facebook page is full of these complaints every day.   Banking the premiums and self-insuring would have been a much better choice for our family.  Since I have already appealed to the NC dept of insurance and they sided with UHC based on my lab work my case is closed.  They tell you upfront that their decision is final and I am not permitted to appeal the result.  So paying 40,000 plus is my only current alternative.  I understand Harvoni may become less expensive down the road but I am making the personal choice to not wait around on things that may or may not happen and are completely out of my control.  I am grateful for my supportive family and the fact that I have the option to make this choice.  I know many do not and I pray for quick reform so that everyone can be treated! 

Offline MEG

  • Member
  • Posts: 304
Re: How do I purchase Harvoni at lowest price available?
« Reply #9 on: March 12, 2015, 09:29:56 pm »
I can't tell you how saddened I was to read your note....I've been in health care for a long time---before the days when insurance companies had so much power. UHC's behavior is abhorrent.

I am very happy that you have the option to pay out of pocket...One last idea is: trying to negotiate a price directly with Gilead. If that's feasible, perhaps starting with 12 weeks at a certain price and see what they do to get you to buy 8? Just thinking here of ways you can save some $$ to put toward your special vacation once you're cured...

Best....keep us posted.
Geno 1a. IL28B+ with TT polymorphism.
Diagnosed 1993.
Liver Biopsy 1993 --inflammation.
Fibroscan 2014---no fibrosis.
ALT range---60s
AST range---80s.
Platelets: 200K range.
Viral load--2 million range.

Began Harvoni on January 23.
Finished 12 week course on April 19.

May 18---4 week EOT labs:
VL: UNDETECTED.
AST: 23
ALT: 22...........These have not been this low throughout treatment and since my 20s.

12 weeks EOT on July 15---Undetected.

Offline slw304

  • Member
  • Posts: 25
Re: How do I purchase Harvoni at lowest price available?
« Reply #10 on: March 13, 2015, 09:05:45 am »
I did call Gilead Support Path after the UHC denials and inquired about their income limit.  I was told to submit an application for an exception.  I sent everything they requested including verification of income, list of expenses, and a heart-felt appeal letter.  I stated in my letter that without assistance I would be forced to withdraw the funds from our retirement account and pay the taxes and penalties. I also explained my symptoms and how they were affecting my life.  I received a call just over two weeks later from a Gilead representative denying assistance because we were over the financial limit.  When I asked him about the exception he told me they were only rarely granted.    Believe me I gave him an earful… asked why they had me bother wasting my time filing all that paperwork and how I was being penalized for working hard and doing the right things in life.  I asked him if I divorced my husband or we quit our jobs would they assist me then?  I asked about any sort of assistance they could provide and explained that since we were over their limits I wasn’t expecting to receive the medication for free but I was hopeful they could provide something additional due to the fact that my insurance refused to pay.  Possibly a 50% discount.  The rep said they didn’t have any other levels of support.  It’s all or nothing, and I don’t qualify.  So in a nutshell, my husband and I have been married for over 20 years, worked hard all our lives, sacrificed to raise two beautiful, successful children, donate weekly to our church, and help support my elderly mother in law but Gilead says I’m not worthy to receive their assistance for treatment.  We now are being forced to make the ultimate financial sacrifice in order to preserve my health.  I don’t believe a nice vacation will be worth much if I don’t feel well.  As I said before I will continue to focus on my many other blessings in life… at least they can’t take that away from me.

Offline C-FIGHTER

  • Member
  • Posts: 43
Re: How do I purchase Harvoni at lowest price available?
« Reply #11 on: March 17, 2015, 07:41:24 am »
Hello Slw,

I am sorry for the trouble you are having to get the medicine you so desperately need. I am curious as to What has your doctor said about this, and is is possible to go for Veikera PacK? Abbie V help?the pills are more but  the success rate is just as good Sovaldi and Olysio? . you have not said anything on this subject. Have more tests been done recently?

Perhaps a change of doctor? 

I was recently approved, but not before i was denied twice by my insurance BCBSIL. a medical board overturne their denial, i think it might be because its possible i have PBC, not truly confirmed yet.  we will test again after i finish Harvoni.  As i thought about what to do if i was not getting Harvoni, the above thoughts came to my head.  As a middle class citizen, household income of a little more than 100 grand it is a JOKE to think people could afford this medicine. keep going at the insurance company, keep fighting, you will get it, perhaps not right now, maybe not today, maybe later this year.  to use your retirement money is a full blown injustice to say the least. There are some good suggestions on this site what to do. 

keep going, and keep posting.

C Fighter.
diagnosed 2010 Hep C
genotype 1b
HCV RNA >4000000 01/13/2015
F0-F1 04/2014
Harvoni March 20 2015 - June 11 - 12 weeks

April 14-Day 26 on Harvoni- Viral Load - UD
ALT 27    AST 27

Offline WaltFrazier

  • Member
  • Posts: 30
Re: How do I purchase Harvoni at lowest price available?
« Reply #12 on: March 17, 2015, 09:40:21 am »
SLW..I too was denied by my insurance company.  I am self employed and pay for my own insurance.  I researched "other" insurance companies that had a track record that paid for harvoni and was on their formulary.  After researching I decided on Humana and changed insurance companies.  I was approved in a matter of days from Humana and on my 29th day of Harvoni.  If your able, I would recommend changing insurance companies.  I was ready to head to India as soon as they started production of Solvaldi.  $900.00for 12 weeks. I would look bnto theose 2 options....Best luck
54 Y-O Genotype 1a Since 1987
TX 2007 48 Weeks INTFR + RIBR ..Hell!
Week 62 Relapse
On Harvoni 12 week
4 Week Undetected!

Offline gug

  • Member
  • Posts: 15
Re: How do I purchase Harvoni at lowest price available?
« Reply #13 on: March 17, 2015, 10:31:04 am »
United Healthcare not approving Harvoni.  They say "not medically necessary".  Gilead Patient Assistance program won't help either because we are over the income level for assistance. I am now being forced to cash in IRA to pay for 8 weeks of treatment.  Does anyone have experience with purchasing Harvoni from Canadian pharmacy online or can anyone offer thoughts on how to get a discounted prescription beyond the co-pay coupon which will apply to first month only?

Good resource and current to what is happening in the Harvoni arena. Within a year or so you will be able to get this in one of 91 countries that Gileads patent doesn't cover.




http://hepatitiscnewdrugs.blogspot.com/2014/03/costly-new-hepatitis-c-drug-raises.html?m=1




http://blogs.wsj.com/pharmalot/tag/harvoni/




$302.00 + 4 the drug in India

http://hepatitiscnewdrugs.blogspot.com/2015/03/natco-pharma-gets-nod-to-sell-hepatitis.html?m=1




http://hepatitiscnewdrugs.blogspot.com/2015/03/10-copy-of-gileads-blockbuster-sovaldi.html?m=1

Offline Debula

  • Member
  • Posts: 257
  • "Your body hears everything your mind says"
Re: How do I purchase Harvoni at lowest price available?
« Reply #14 on: March 17, 2015, 01:54:12 pm »
Hi Slw304
I am so sorry to hear this news
I too have Untied Healthcare and now I am worried
I will be going back to the Dr. on the 27th and I was hoping that I too would be put on Harvoni.  I looked up the drug on UHC and it said that I can get this drug with pre-approval with a co pay of about $119.00 for 30 day supply
So you are saying my pre-approval may not go through.  :(
Is your plan a PPO?  Just curious to see if all members/plans of UHC will be denied
I hope you find a way and I hope I do too!
« Last Edit: March 18, 2015, 09:58:53 am by Debula »
80's DX: NonA,B
Non responder to Interferon
3/6/2015-GT 1a
VL-1920000 IU/mL
FibroSURE: Fibrosis stage F4 (0.79)
                  Necroinflammat activity A3 Severe (0.75)
AST 88,  ALT 120, Platelets 73
4/16/2015-Started Harvoni (24 weeks)
5/13/2015-4 weeks AST 26, ALT 36 
5/22/2015-5 weeks  VL UND
6/17/2015-9 weeks  VL UND AST 28 ALT 40
7/31/2015-15 weeks VL UND AST 27 ALT 39
9/22 Diagnosed with HCC
10/1-EOT
10/29-SVR4
12/23-SVR12
I AM HEPC FREE! :)

Offline SIXFOOTFOUR

  • Member
  • Posts: 89
Re: How do I purchase Harvoni at lowest price available?
« Reply #15 on: March 17, 2015, 02:48:41 pm »
Debula

Search this forum and a few others . The approval seems to be different from one insured to another under the same basic plans. 

I was originally denied because the prescription provider for my Blue Cross Blue Shield is Express Scripts and they made a deal to use Viekira Pak because they got a discount on it  but my Doctor pushed and we provide additional info (old biopsy, new scans and blood work as well as why the Viekira was more expensive due to the need for more monitoring during tx) And  60 days later I recieved my bottle of 28 with the Support path discount to make my co pay $ 5.

I believe its worth the fight and if necessary a slight wait to get Harvoni over any other as the ease of 1 pill a day and min side effects with high percentage of results makes it all worth the wait.

If I had not been approved this time around I think I might have waited 6 months and tried again before accepting any other choices. Im F3-4 and VL 6 mil plus Ive had this in me for 35 + years and a few more months to get the best and easiest treatment makes sense to me. I believe that it will only get easier to be approved over the next year as the success of treatment becomes more documented

Best of luck, dont take no as your answer
Sixfootfour
* Contracted Hep C 1971 post transfusion (non A - non
   B Hep dx in 1971)
* Dx as Hep C early 2000
* Geno 1b
* Stage 3-4 Fibrosis by Biopsy and FibroScan
* VL at start of TX > 6 mil
* ALT/AST High normal range at start of Tx 
* Started Harvoni 12 week course 3/6/15 -
   completion 5/29/15
* Undetected at 6 weeks on Tx
* ALT/AST Mid normal range at 6 week blood test
* Completed 12 weeks (84 pills) 6/28/15
* Undetected at 11 weeks & 6 months EOT

Offline Debula

  • Member
  • Posts: 257
  • "Your body hears everything your mind says"
Re: How do I purchase Harvoni at lowest price available?
« Reply #16 on: March 17, 2015, 03:17:47 pm »
Thank you Sixfootfour!  I don't plan on giving up but I am a bit disappointed that this will probably happen to me too.  So I'm guessing the doctor will try to push some other drug on me.  Is there anything out there that is as good as Harvoni?  Assuming of course I am genotype 1.  I will find that out on the 27th also.
I guess I was hoping that I would go in to my appointment on the 27th and be put on Harvoni within the next day or two.  I guess I really am jumping the gun here
80's DX: NonA,B
Non responder to Interferon
3/6/2015-GT 1a
VL-1920000 IU/mL
FibroSURE: Fibrosis stage F4 (0.79)
                  Necroinflammat activity A3 Severe (0.75)
AST 88,  ALT 120, Platelets 73
4/16/2015-Started Harvoni (24 weeks)
5/13/2015-4 weeks AST 26, ALT 36 
5/22/2015-5 weeks  VL UND
6/17/2015-9 weeks  VL UND AST 28 ALT 40
7/31/2015-15 weeks VL UND AST 27 ALT 39
9/22 Diagnosed with HCC
10/1-EOT
10/29-SVR4
12/23-SVR12
I AM HEPC FREE! :)

Offline SIXFOOTFOUR

  • Member
  • Posts: 89
Re: How do I purchase Harvoni at lowest price available?
« Reply #17 on: March 17, 2015, 03:26:54 pm »
Debula

It very frustrating to know there are these amazing new generation of drugs with high 90% success and almost no side effects like to previous meds available.

If you cant get Harvoni try for Viekira Pak the success is basically the same. Its more pills a day (I think 5 in the am and 2 pm) and requires a little more monitoring. Side effects are minimal but slightly more than reported by Harvoni users.

Good luck
Sixfootfour
* Contracted Hep C 1971 post transfusion (non A - non
   B Hep dx in 1971)
* Dx as Hep C early 2000
* Geno 1b
* Stage 3-4 Fibrosis by Biopsy and FibroScan
* VL at start of TX > 6 mil
* ALT/AST High normal range at start of Tx 
* Started Harvoni 12 week course 3/6/15 -
   completion 5/29/15
* Undetected at 6 weeks on Tx
* ALT/AST Mid normal range at 6 week blood test
* Completed 12 weeks (84 pills) 6/28/15
* Undetected at 11 weeks & 6 months EOT

Offline Debula

  • Member
  • Posts: 257
  • "Your body hears everything your mind says"
Re: How do I purchase Harvoni at lowest price available?
« Reply #18 on: March 17, 2015, 03:29:50 pm »
My Specialty pharmacy thru UHC is OptumRX

  Harvoni TAB 90-400MG  Coverage Alert 
 OptumRx® Mail Service Pharmacy
30-Day Supply  30
 $119.55  N/A

 
NDC: 61958180101

This is a Brand name drug
About this drug  Plan Pays: 30
 $33,697.95   
Total Cost: 30
 $33,817.50   
 Coverage Alert
This medication requires a Prior Authorization before coverage will be provided. Your doctor should contact us.

 
  Harvoni TAB 90-400MG Coverage Alert 
 CVS PHARMACY 09698
30-Day Supply  30
 $119.55 
NDC: 61958180101

This is a Brand name drug
About this drug  Plan Pays: 30
 $33,901.45   
Total Cost: 30
 $34,021.00 

I am trying to find out where some people found the guidelines for the pre authorization
80's DX: NonA,B
Non responder to Interferon
3/6/2015-GT 1a
VL-1920000 IU/mL
FibroSURE: Fibrosis stage F4 (0.79)
                  Necroinflammat activity A3 Severe (0.75)
AST 88,  ALT 120, Platelets 73
4/16/2015-Started Harvoni (24 weeks)
5/13/2015-4 weeks AST 26, ALT 36 
5/22/2015-5 weeks  VL UND
6/17/2015-9 weeks  VL UND AST 28 ALT 40
7/31/2015-15 weeks VL UND AST 27 ALT 39
9/22 Diagnosed with HCC
10/1-EOT
10/29-SVR4
12/23-SVR12
I AM HEPC FREE! :)

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,493
  • Get tested, get treated, get cured, fight Hep c!
Re: How do I purchase Harvoni at lowest price available?
« Reply #19 on: March 18, 2015, 12:30:10 am »
Not sure this applies to your exact insurance situation but worth a read

https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Pharmacy%20Resources/Harvoni_Medical_Necessity.PDF

Prior Authorization/Medical Necessity Harvoni™ (ledipasvir/sofosbuvir) 10/15/2014

It is 11 pages for many different situations

Good Luck
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Debula

  • Member
  • Posts: 257
  • "Your body hears everything your mind says"
Re: How do I purchase Harvoni at lowest price available?
« Reply #20 on: March 18, 2015, 10:02:28 am »
Not sure this applies to your exact insurance situation but worth a read

https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Pharmacy%20Resources/Harvoni_Medical_Necessity.PDF

Prior Authorization/Medical Necessity Harvoni™ (ledipasvir/sofosbuvir) 10/15/2014

It is 11 pages for many different situations

Good Luck

Thank you Lynn.  I looked everywhere on my UHC site and could not find this  :P
80's DX: NonA,B
Non responder to Interferon
3/6/2015-GT 1a
VL-1920000 IU/mL
FibroSURE: Fibrosis stage F4 (0.79)
                  Necroinflammat activity A3 Severe (0.75)
AST 88,  ALT 120, Platelets 73
4/16/2015-Started Harvoni (24 weeks)
5/13/2015-4 weeks AST 26, ALT 36 
5/22/2015-5 weeks  VL UND
6/17/2015-9 weeks  VL UND AST 28 ALT 40
7/31/2015-15 weeks VL UND AST 27 ALT 39
9/22 Diagnosed with HCC
10/1-EOT
10/29-SVR4
12/23-SVR12
I AM HEPC FREE! :)

Offline Lynn K

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Re: How do I purchase Harvoni at lowest price available?
« Reply #21 on: March 20, 2015, 08:04:49 pm »
The date was just after Harvoni was approved so probably there have been changes since then but kinda give you an idea
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline annak269

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Re: How do I purchase Harvoni at lowest price available?
« Reply #22 on: August 10, 2015, 11:41:02 pm »
Very sorry to hear about your situation. Can you please let us know what has happened since you last posted?

Offline sickpuppy

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Re: How do I purchase Harvoni at lowest price available?
« Reply #23 on: August 11, 2015, 06:51:47 am »
Generic Harvoni is coming to India in December at $1000 a bottle. The manufacturing process is leased and supervised by Gilead so you can be sure it's the same thing, just without the Harvoni brand.
GT1a - TX-naive

Baseline:

16.2 kPa
ALT: 61 iu/L
ALP: 74 iu/L
Albumin: 38g/L
Bilirubin: 27 umol/L
Platelets: 80
VL: 792,000
History of 4 violent varices bleeding episodes and splenomegaly present.

21/07/15 - TX start - Harvoni + Ribavirin 12 weeks.
Week 2 - UND
Week 4 - UND
Week 8 - UND
13/10/15 Week 12 - UND
19/11/15 - SVR4
8/1/16 - SVR12 !!!!!

Offline gnatcatcher

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Re: How do I purchase Harvoni at lowest price available?
« Reply #24 on: August 11, 2015, 08:01:15 am »
slw304, I'm glad sickpuppy and others have answered your primary question: how to obtain 4 weeks of Harvoni for much less than the sticker price. It sounds as though if you can hold off for six months to a year, you won't have to sacrifice so much financially. Since you are F1 and your VL is under a million, unless your ALT and/or AST are sky high or some other lab result worries your doctor, it might be helpful to find out how long your doctor thinks you can safely wait to start treatment. I can definitely relate to your anger and your desire to get this behind you ASAP. The tricky thing now is to be able to make decisions in a calm, centered state so that they are the best possible decisions. You are in my heart -- in a peaceful chamber I've reserved exclusively for you.
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline Marynessie

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Re: How do I purchase Harvoni at lowest price available?
« Reply #25 on: March 16, 2016, 02:08:34 pm »
Did you finally get treatment?

Offline Lynn K

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Re: How do I purchase Harvoni at lowest price available?
« Reply #26 on: March 16, 2016, 02:18:54 pm »
Hi Marynessie and welcome to the forum

The OP has not visited the site since Aug 2015 but looking at his last couple of posts he did treat and was cured.

If you click on his name you can search his profile as read his old posts.

Is there anything we can help you with?
« Last Edit: March 16, 2016, 07:21:11 pm by Lynn K »
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline Joe NM

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Re: How do I purchase Harvoni at lowest price available?
« Reply #27 on: March 16, 2016, 06:49:49 pm »
Original poster! Have you/your doctor tried just putting in the prescription again/starting over? All the non-Medicaid UHC plans very recently changed their standards and no longer have fibrosis restrictions, so from what I can tell, you should get 8 weeks of Harvoni approved if you try again.

Sorry if you've already tried this and I'm mistaken.

Here's the current UHC coverage policy for Harvoni, which they have said applies to all non-Medicaid plans (already posted above, but here it is again anyway): https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Pharmacy%20Resources/Med_Nec_Harvoni.pdf

Notice that it says they want you to have had an assessment of fibrosis, but NOT that you have to actually have a certain stage to be approved.
Also, see page 2, which could hold some people up (only restriction left, really): if you have a past history of alcohol or drug abuse, you will need to have a negative urine drug screening within 30 days of your doctor's office submitting a Prior Authorization. It can also be helpful for your doctor to note if you haven't used drugs or alcohol in the past 6 months (however, it doesn't sound like this was the issue for which you were denied).

The loosening of restrictions has rolled out at different times in different states, so maybe the luck wasn't going your way. Either way, you ARE free to try the process again, and you might find your luck is different.

Also, once you're approved, get that copay coupon from Support Path! Gilead might as well pay up for any of your copays, after all you've been through.

Try contacting this organization: https://hepatitisc.pafcareline.org/  if you want extra case management/advocacy services to help out with this (though it sounds like you may have more experience than them!)

Or check out generic Harvoni from overseas through a buyer's club (around $2,000 for the whole course of treatment): http://fixhepc.com/ (also, check out Gregg Jefferys' blog, https://www.hepmag.com/blogger/greg-jefferys)
HCV Case Manager
Type-1 diabetic
Connoisseur of battling insurance companies, and when that fails resorting to 'Sample Pharmacies' and sneaking insulin back from Mexico to survive.
Kindred spirit/admirer of all on this forum!
Here to help in any way I can!
EVERYONE DESERVES A CURE!

Offline Lynn K

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Re: How do I purchase Harvoni at lowest price available?
« Reply #28 on: March 16, 2016, 07:21:26 pm »
Hi Joe NM

As I mentioned the OP slw304 has not been around since last August.

This was one of his last posts

"Hi Everyone... so excited to report my test results received today - 10 wks EOT undetected!  I did 8 weeks of Harvoni (Liver Biopsy F1, VL < 1mil, Self Paid)"

http://forums.hepmag.com/index.php?topic=3163.msg26332#msg26332

So sounds like he is cured and why he has not been around since

Another one bites the dust
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline beto

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Re: How do I purchase Harvoni at lowest price available?
« Reply #29 on: March 16, 2016, 07:23:54 pm »
Send a message to Coach Mike.  He knows the most about the generics and has helped others.

I have UHC and was denied 4 times...keep trying and bug the S out of em'.  Write a letter (a strong one) and send it to every one at UHC and copy anyone that can help outside of UHC.
HCV/nonA,nonB acute phase 1975
HCV detected active 1990
HCV persistent chronic diagnosis 1995
1995 liver enzymes mild elevations
1996 Biopsy F2 fibrosis
treatment naive geno 1-A
2000-to early 2015 Viral load 150, 000 to 800, 000
recent liver enzymes before treatment alt/ast 59to209,  Fibroscan F4,cirrhosis
start tx Harvoni 7/11/2015
6.5 week-UD-ast/alt 25/25
9wk-UD-ast18 alt23
10/3/15 completed tx
11/5/15 new fibroscan f0-f1 amazed
6wk EOT UD ast/alt 20/20
12EOT-UD-ast/alt19/21
25wk-SVR! 19/18

 


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