Hepatitis C Main Forums > Hepatitis C Awareness and Activism

Big Pharma & Big Profits: The The Truth Comes Out

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mikeo52:
is it safe to assume that doctors out there are getting kick-backs for using particular vendors or suppliers for hep c drugs?

gnatcatcher:
Aren't there a few more moving parts here? Insurers who control who gets approved for treatment and which treatments they'll cover? Prescription benefit handlers such as CVS Caremark (which made a deal with Harvoni) vs. Express Scripts (which made a deal with vPak)? Large employers who self-insure (using brand-name insurers to handle the paperwork) and pick a single prescription benefit manager for however many health plans they offer? My hepatologist normally works with one specialty pharmacy, but the employer footing the bill for my tx uses only CVS Caremark's specialty pharmacy for all of the insurance plans available to employees, so my hepatologist's specialty pharmacy passed the prescription on to CVS Caremark. There are other similar examples in some of the 2015 threads.

mikeo52:
THAT'S VERY INTERESTING! THE REASON I ASK IS BECAUSE MY DR.HAS ALREADY SUBMITTED FOR APPROVAL OF A 12 WEEK TREATMENT FOR ME. THAT WAS OVER A MONTH AGO! I JUST CANNOT SEEM TO GET ANY ANSWERS AS TO WHY THINGS @ THIS POINT ARE MOVING SO SLOW!I'M TRYING TO BE PATIENT, BUT FOR ME THIS WHOLE PROCESS HAS GIVEN ME A LOT OF ANXIETY. I DON'T KNOW WHO TO TURN TO FOR INFORMATION AND I'M REALLY STRESSED OUT OVER IT.

MIKE

gnatcatcher:
When I saw the hepatologist to get a Harvoni prescription, he and the nurse told me to expect it to take around 3 months before insurance approved and the medicine arrived. (That was even though I took within 48 hours all the tests they said the insurance companies want.) They were surprised when I received the insurance approval letter in only seven-and-a-half weeks.

mikeo52:
THANKS GNAT, AT LEAST THIS GIVES ME AN IDEA AS TO WHAT TO EXPECT. IF YOU DON'T MIND ME ASKING, WHO IS YOUR INSURANCE CO? MINE IS AETNA

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