Author Topic: Well, this is one right out of the Twilight Zone (Read 18885 times)

davidsconfused · « **on:** January 23, 2015, 07:58:28 am »

I had to wait until my Medicaid Part D started Jan 1 for my doctors office and pharmacy to send in the approval papers to my insurance company, get turned down twice, then to Support Path to get the Harvoni paid for. I still hadn't heard anything so Monday, the 20th I called my doctors office and talked to the Hep C Coordinator. Evidently the pharmacy dropped the ball and hadn't sent in the request to my insurance co. $:-\$

The doctors office called the pharmacy, the pharmacy called me, made sure they had all the info they needed and sent the request to the insurance co. Less than 12 business hours later the pharmacy called me back and told me the insurance co had approved me! I was shocked! The copay request has been sent to Support Path where there shouldn't be any problem, so I should have my Harvoni by the middle of next week according the the pharmacy.

Just for FYI, the Part D insurance co was Humana Walmart, the cheapest Part D Plan I could get. I REALLY didn't expect for them to pay for the Harvoni. I just got them for other prescriptions.

lporterrn · « **Reply #1 on:** January 23, 2015, 04:38:27 pm »

Wow - let us know when you start. Looks like you are on your way to a new life.

Mike · « **Reply #2 on:** January 23, 2015, 05:56:17 pm »

Hi David,

I remember you were debating about signing up for part D and you had to make a fast decision (or be penalized).

I'm glad this worked out. You beat the part D deadline, beat the penalty, beat the insurance company, and now you're going to beat the dragon!

Really great news to hear!

Best wishes, Mike

BattleTheBeast · « **Reply #3 on:** January 23, 2015, 08:32:18 pm »

Great news! Before you know it you are going to feel 20 years younger!

Mel

davidsconfused · « **Reply #4 on:** January 24, 2015, 06:00:53 am »

Quote from: BattleTheBeast on January 23, 2015, 08:32:18 pm

Great news! Before you know it you are going to feel 20 years younger!

Mel

I need it. In the last three years I've felt like I've got 20 years older.

davidsconfused · « **Reply #5 on:** January 24, 2015, 06:18:06 am »

My doctors office called today (well, yesterday now, I'm still up) )and told me I'd been approved for Harvoni not knowing the pharmacy had already called, so I guess it's real.

The pharmacy had before had told me I'd been approved, went through all the side affect and interaction info, then transferred me to someone else on that call who looked it up and told me I wasn't so this time I was kind of waiting for the other show to drop and them telling me I actually wasn't approved. My luck usually doesn't run this good.

I've had Hep C for 40 years last September but I have high hopes it won't be another year.

BattleTheBeast · « **Reply #6 on:** January 24, 2015, 10:02:34 am »

David,

That's such great news, I am so happy for you! You will on your way to SVR very soon. Here's my input for what it's worth:

- Drink lots of water, you can't drink too much. Try to make it water without the additives like Aquafina and Dansani have (read their bottles). If you are lucky you live somewhere that has great tap water

- Listen to your body, if you feel tired or crappy then rest. You are going to be in a huge battle to rid your body of this virus.
- Eat as healthy as you can stand it
- Exercise when you feel up to it, even just walking is a good thing when you feel good. I like to think it's jarring any left over bad virii in my body so the medication can find it and wipe it out

- You may have some sides but they really do get better and it's nothing like you would get with an Interferon treatment. Don't self medicate from them, check with your doctor before taking anything even OTC.
- Heartburn - if you do get heartburn you need to have a minimum 4 hour window between the medication and any heartburn meds even Tums. I only take something if I am in misery otherwise I just water my way through it or may resort to a GingerAle or Sparkling water to help.
- When you aren't sure, ask your doctor. It's their job to get you to the end with an SVR outcome.
- Tons of knowledge here on the forum, ask all the questions you want!

It's all uphill from here, you've got this!

Mel

davidsconfused · « **Reply #7 on:** January 28, 2015, 04:41:11 pm »

I knew it, I knew it, I knew it.

I got a call from the pharmacy last night but by the time I called the person back they were gone for the day. I spent half of today trying to get them on the phone and finally managed an hour or so ago. I assumed they were calling to tell me the Harvoni had been shipped.

They were calling to get my financial info to send in the copay request.

I told her that I had been told last week that they had verified they had all my financial info, that the copay request was being sent in then and the Harvoni should have been shipped by now. Well, no nothing had been sent in for the copay request and she needed to get my financial info. After I told her that it had been sent in a long time ago there was some key clicking on her computer, then "oh yea, we got that back in December" AARRRGGG.

She told me that she could submit the copay request a different way, she should know something in 30 minutes and would call me back as soon as she did. Sure enough, she called me back fairly quickly and it had been approved. My doctors office wanted it to go to them for the first round so the Harvoni should be at their office Friday.

Just for an interesting FYI - I can see why Harvoni is getting approved better. It is not costing the insurance company anywhere near list price. The best I can tell they are paying about half price. I have a 25% copay and my copay for the month is $3922.33 so unless my math is wrong that is slightly less than $16,000 a month.

Mike · « **Reply #8 on:** January 28, 2015, 05:36:29 pm »

Hey Dave,

I'm glad it's finally getting shipped. Could job having some patience - I'd have been screaming!

Best wishes, Mike

Lynn K · « **Reply #9 on:** January 28, 2015, 06:58:27 pm »

Just to clarify the specifics about antacid treatments

http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf

see table 3 page 5 of the prescribing information.

Acid Reducing Agents:

Ledipasvir solubility decreases as pH increases. Drugs that increase gastric pH are expected to decrease concentration of ledipasvir.

Antacids (e.g., aluminum and magnesium hydroxide)
It is recommended to separate antacid and HARVONI administration by 4 hours.

H2-receptor antagonistsc (e.g., famotidine)
H2-receptor antagonists may be administered simultaneously with or 12 hours apart from HARVONI at a dose that does not exceed doses comparable to famotidine 40 mg twice daily.

Proton-pump inhibitorsc (e.g., omeprazole)
Proton-pump inhibitor doses comparable to omeprazole 20 mg or lower can be administered simultaneously with HARVONI under fasted conditions.

So if you take Tums or similar separate the dosing from Harvoni by 4 hours so no later than a minimum of 4 hours before Harvoni and no sooner than a minimun of 4 hours after taking Harvoni.

If you take H2-receptor antagonistsc (e.g., Tagamet, Zantac, Axid, Axid AR, Pepcid, Pepcid AC) They must be taken SIMULTANEOUSLY with or 12 hours apart from HARVONI at a dose that does not exceed doses comparable to famotidine (Pepcid) 40 mg twice daily.

If you take Prilosec or other Proton-pump inhibitors (PPI) (Omeprazole (OTC; brand names: Gasec, Losec, Prilosec, Zegerid, ocid, Lomac, Omepral, Omez, Omepep, UlcerGard, GastroGard) Lansoprazole (brand names: Prevacid, Zoton, Monolitum, Inhibitol, Levant, Lupizole) Dexlansoprazole (brand name: Kapidex, Dexilant))

They must be taken SIMULTANEOUSLY with HARVONI under fasted conditions.

Personally I normally was taking Prilosec but am only taking Tums and generally trying to avoid that unless I can't sleep because of heartburn (I have GERD) 24 weeks of heartburn is a small price to pay for SVR

Lynn K · « **Reply #10 on:** January 28, 2015, 07:02:33 pm »

David

Have you looked into the Support Path copay coupon? I only pay $5.00 a bottle for Harvoni

https://www.harvoni.com/co-pay-coupon-registration?evo_source=MYSUPPORTPATH&_ga=1.27021685.973567089.1408674970

Pay no more than $5 per co-pay for HARVONI

We believe that cost should not be a barrier to receiving treatment. That’s why the makers of HARVONI offer a co-pay coupon. If you are eligible, you may pay no more than $5 per co-pay. Some restrictions may apply. See Terms and Conditions below.

1-855-7-MYPATH (1-855-769-7284)

davidsconfused · « **Reply #11 on:** January 30, 2015, 04:42:23 pm »

Quote from: Lynn K on January 28, 2015, 07:02:33 pm

David

Have you looked into the Support Path copay coupon? I only pay $5.00 a bottle for Harvoni

They didn't go through Support path, they went through someplace else. I'm not even paying the $5.

davidsconfused · « **Reply #12 on:** January 30, 2015, 04:50:15 pm »

According to tracking my Harvoni was delivered to my doctors office at 9:40 am this morning. Unfortunately they close at noon on Friday so I didn't get them or hear from the doctor's office today. I will be on the phone as soon as they open Monday, though.

Oh well, I've evidently had Hep C for 40 years, 4 months and 5 days so I guess it will wait until Monday or Tuesday.

Mike · « **Reply #13 on:** January 30, 2015, 05:02:50 pm »

Hi David,

Given the wait and hassle it took getting these meds, I'd be at the doctors office banging on the door at 6:00 AM Monday morning!

Best wishes, Mike

Lynn K · « **Reply #14 on:** January 30, 2015, 10:11:07 pm »

Congrats David on almost having the meds in hand and yeah what Mike said!

davidsconfused · « **Reply #15 on:** February 05, 2015, 04:52:38 pm »

I FINALLY have my Harvoni in my hands as of 2:00pm this afternoon. This is the soonest I could get an appointment to come in and get it.

I'll be taking the first one at 9:00 tomorrow morning. That sure doesn't look like $16,000 in that bottle! At least this part is over with.

Lynn K · « **Reply #16 on:** February 05, 2015, 10:25:03 pm »

They must be getting a serious discount on the pricing now. It was $31,500.00 a bottle for a 28 day supply

kate0b1 · « **Reply #17 on:** February 06, 2015, 06:46:51 am »

@davidsconfused, happy first day, don't forget the water

kate

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Author Topic: Well, this is one right out of the Twilight Zone (Read 18885 times)