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Author Topic: Harvoni and insurance  (Read 5315 times)

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Offline drummerman

  • Member
  • Posts: 538
  • For those regarded as warriors....
Harvoni and insurance
« on: May 18, 2015, 12:16:18 pm »
Hello all,

New to this forum and waiting to hear from my insurance company regarding
harvoni rx.

previous tx with peg and inter = non-responder.
Grade 1 on last biopsy about 4 years ago.  Non drinker since the day I found out I was infected... 9 years ago.

Not feeling real good about possible insurance pay based on what I am reading
here and other forums.

Combine income about 125,000 so probably make too much for gilead to pay.

Just curious , has anyone had success with blue cross covering harvoni??

thanks!
jpritch
Diagnosed07
Interferon/riba 2008 - non-responder
5/16/15 - AST -34
ALT - 35_ HCV RNA - 10,783,000
 7/6/15 - started viekira/riba
8/11/15  Week 5 <15 vl,  AST 18, ALT 18
9/11/15 Week 9  "HCV NOT DETECTED"!
AST 16, ALT 11.  10/16/16 - 2 weeks post EOT = "HCV NOT DETECTED!   AST - 18,  ALT 14
12/29/15 -12 wk EOT-HCV NOT DETECTED! AST 23, ALT 15
3/26/16 - 24 wk post EOT - HCV NOT DETECTED!! AST 19, ALT 21
1 yr eot - AST 20, ALT 17

Offline SIXFOOTFOUR

  • Member
  • Posts: 89
Re: Harvoni and insurance
« Reply #1 on: May 18, 2015, 01:00:57 pm »
There are a few threads about this.

Im a BC insured and have prescription coverage through Express cripts  from BC.

IThey approved me but wanted to use Viekira pak since they have a deal with them and get it at a reduced price. My md pushed and I was approved for Harvoni, am in my last 11 days now of  12 week treatment.

A lot has to do with your VL if it is  above  6 mil and fibrosis is  3-4 they are approving almost all i talk to or read about. VL lower than 6 mil and Fibrosis 0-1-2 and they will try to get you to wait or use the product they have a deal wit in most cases its Viekira pak

Be your own advocate and dont take no. My experience with Harvoni is amazing, next to no side effects, tested not detected at 7 week (first test) and `feel great, waiting for my 9 week test results and them my MD will do EOT tests and 12 week  , 6 month and 1 yr
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

 


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