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Author Topic: Denied Harvoni need suggestions  (Read 10512 times)

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Offline frooze

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  • Posts: 10
Denied Harvoni need suggestions
« on: March 29, 2015, 04:25:43 am »
Hi, Express Scripts Denied Harvoni but said they would supply Viekira Pak with Ribavirin instead.  I want my doctor to fight for me but it seems he wants to talk to me Monday morning and try to convince me to go with Express Scripts recommendation. 

   I already sent an email to Express Scripts making them aware that I do not have a spleen and only have one kidney.  As a child while on the sidewalk I was hit by a car driven by a drunk driver.  Dr. Hoffman at Mercy hospital in Pittsburgh saved my life.  I was severely injured, lost a lot of blood and required surgery.  My spleen and one kidney were removed and I was in a coma for several weeks.

   Since my liver has to do more work because of the loss of my spleen, I try not to do anything to cause more damage to my liver.  I don’t drink alcohol, smoke cigarettes or take any pain medication like Tylenol or aspirin because they get processed by the liver.  In the 1990’s I found out that I have the life threatening conditions of cirrhosis and HVC.  I can only assume that the blood transfusions I was given as a child caused these conditions.  I currently take medication for high blood pressure and prostate problems.  I have been prescribed Gabapentin described as being less harmful to my liver for my back pain and I don’t take it because of my liver disease.

   I was ready for a single pill treatment for my HVC condition.  Remember I have only one kidney and my spleen was removed.  I try to take as few pills as possible to not over burden my liver.  I don’t need all these extra pills that one pill can do, with hopefully the same result.

Can anyone help me on what to tell my Doctor on Monday, so he'll fight Express Scripts and hopefully get Harvoni for me?  I appreciate any and all suggestions.
« Last Edit: March 29, 2015, 04:31:27 am by frooze »
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Offline Lynn K

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  • Member
  • Posts: 4,544
  • Get tested, get treated, get cured, fight Hep c!
Re: Denied Harvoni
« Reply #1 on: March 29, 2015, 04:41:47 am »
Does your doctor have any reservations about treating you with your other medical conditions with Viekira? Are any of the meds you take counter indicated with either Viekira or Harvoni?

What kind of doctor are you seeing a hepatologist? Have you treated before and do you have cirrhosis.

If it can't be shown that there is a medical reason you cannot treat with Viekira I am not very optomistic for your chances.

On that email did you send your subscriber number and contact information to ExpressRxHelp@express-scripts.com ? That was how I was able to get my meds after they initially denied me. Did they contact you back? What did they say?

Only other suggestion is after you get 2 letters of denial you can see if you can get help from Giliead Pharmacuticals at there  my Support Path site they have provided the meds for some free of charge with income restrictions and I guess if your insurance is through social security you are not eligible.

http://www.mysupportpath.com

Wish I had better news
Logged
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 frooze

  • Member
  • Posts: 10
Re: Denied Harvoni need suggestions
« Reply #2 on: March 29, 2015, 01:08:45 pm »
Hi, I don't know what reservations the Doctor has, I guess I'll find out Monday.  My Doctor is a hepatologist.  I was diagnosed with cirrhosis and HVC when I had a bioposy in the 1990's by the same Doctor. 

I have never been treated before because I was aware of the low success rate and the severe side effects of the treatment. 

I waited all this time hoping for miracle, something like Harvoni and now facing Viekira and (god forbid) Ribavirin.  I can't deal with the possible side effects of Ribavirin and Viekira.  This is why I didn't opt for treatment in the past.

I'm at the point if I can't get Harvoni I'll refuse Viekira and just wait it out, hopefully not to my detriment.

I was here as a guest earlier last week and seen info you listed on contacting  ExpressRxHelp@express-scripts.com and I did, thank you for that Lynn.  They called me the next day and asked if I had recent blood work and if I ever had treatment before.  The next day, I stopped in at my Doctor's office and found out Express already sent forms for the Doctor to fill out.  I had at this point no further news on this account.

Monday is a very important day for me, hopefully I can convince the Doctor a appeal Express Scripts intent to supply Viekira Pak.  I'm not sure what to say to him other then I need him to fight for me. 

I appreciate any help I can get.  Any suggestions?



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Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,544
  • Get tested, get treated, get cured, fight Hep c!
Re: Denied Harvoni need suggestions
« Reply #3 on: March 29, 2015, 07:02:41 pm »
I don't know with having cirrhosis if waiting is a great idea how long have you been diagnosed with cirrhosis? Are you considered compensated or decompensated?

I take a diuretic for my edema and a small amount of ascities due to my cirrhosis plus I have had esophageal varicies that required banding. I was diagnosed with cirrhosis in Jan 08 and had developed the varicies by 2012.

Currently I am finishing week 19 Harvoni and week 10 of Ribavirin. I will say riba is not fun as I am very anemic but I will make it and hopefully be free from hep c so hopefully I can avoid decompensation and the need for a transplant if I am fortunate enough to get one in time. 

They only suggestion I have is to read the prescribing information for Viekira Pak and Ribavirin for the contraindications that is where you will find your argument against those meds. I would also look at the prescribing information for Harvoni it may be that Harvoni could be counter-indicated for you with your other conditions and meds you take.

http://www.rxabbvie.com/pdf/viekirapak_pi.pdf

http://kadmon.com/files/ribasphere-tablets-pi.pdf

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

  • Member
  • Posts: 267
Re: Denied Harvoni need suggestions
« Reply #4 on: April 04, 2015, 06:39:42 pm »
Hi froze,

I agree with you on the treatment ...  I think Harvoni is best...

 I'm f4 and have not been treated before, also I've been prolly infected since 76,
But I have lived since 78 with a healthy lifestyle, and my symptoms are not severe,

I would fight for the Harvoni, but if had no choice I would take treatment over not taking it...

Don't leave any stone unturned....  It's your health.... Fight for it...
I support you...

God bless
Logged
Age 57 male
Infected late 70's
Diagnosed 95
1a, 2 prev biopsy 95, 2004
Ct 2007, 2015
Treatment Naive
F4 A3. Fibrosure/ CT 2-5-15. Ammonia 222
VL 2.2 mil.
Started Harvoni  3-3-15. 12weeks, finished 5-26-15
4 week VL undetected
12 week EOT undetected

Offline frooze

  • Member
  • Posts: 10
Re: Denied Harvoni need suggestions
« Reply #5 on: April 05, 2015, 12:15:43 am »
Oh well, Monday I meet again with my Doctor and have him write the prescription for Viekira Pak. He says chances of me getting Harvoni are like a snowball in hell.  In the 7 days I asked my Doctor for to decide, I found out a lot about both treatments and noticed that several people had heart attacks and died and were on Harvoni. I don't know what the connection with Harvoni but the stock took a Hit.  I just want to get rid of this devil inside of me and the sooner the better.  The best thing that happened is that I joined proCeed and my co-pay went from almost $1800 dollars to $5 dollars.  Very extremely happy about that, as you can imagine.  So wish me luck and I'll keep everyone informed.  I'm so happy for this forum, it's nice to know that I'm not going into this alone. 
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Offline Lynn K

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  • Member
  • Posts: 4,544
  • Get tested, get treated, get cured, fight Hep c!
Re: Denied Harvoni need suggestions
« Reply #6 on: April 05, 2015, 02:07:21 am »
Some people with existing heart conditions taking a specific medication had a problem

9 patients taking hep C drugs with amiodarone develop bradycardia, 1 dies and 3 need pacemakers

http://www.fiercepharma.com/story/gilead-warns-fatal-reaction-sovaldi-harvoni-and-heart-drug/2015-03-23
Logged
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!
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