Hepatitis C Community
How much are you paying for Sovaldi out of pocket?
About This Community:

This forum is for questions about medical issues and research aspects of Hepatitis C such as, questions about being newly diagnosed, questions about current treatments, information and participation in discussions about research studies and clinical trials related to Hepatitis. If you would like to communicate with other people who have been touched by Hepatitis, please visit our new Hepatitis Social/Living with Hepatitis forum

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

How much are you paying for Sovaldi out of pocket?

I'm looking to treat next year and was wondering how much people with insurance are paying out of pocket. I heard that it's $1000 a pill for Sovaldi. We have insurance but it's a high deductible and I don't quite understand how much it would end up costing. Am I really going to have to pay $6000 a month for these things?
If it was 100% guaranteed that I'd reach SVR I'd find the money from somewhere but having failed 3 times before, I'm sort of skeptical. Any thoughts will be appreciated.
15 Comments Post a Comment
Blank
Avatar_f_tn
My insurance (Coventry - Aetna Specialty Pharmacy) covers all but $250/month for Sovaldi, and $250/month for ribavirin. Gilead pays (per coupon) pays all but $5,00 of the Sovaldi per month and Ribasphere coupon pays all but $25.00/month. I pay $30/month copay for both. The good news (which insurers hate) is that the co-pay amounts should go toward your insurance deductable/out-of-pocket costs. Joanne.
Blank
Avatar_f_tn
F:  Like Joanne, my insurance covers their portion.  I have Medicare with United HealthCare through AARP for a supplement.  Between them they pay all but $3800.00 per month.  The Specialty Pharmacy filed for to the PAN Foundation for me and they are picking up EVERYTHING else.  I have no copay at all, thanks be to God, insurance and the PAN Foundation.

Your Dr's Office might start the ball rolling.  Mine did.  ALL I had to do was give them a little info that dr did not have in his file re # in family, annual income, oh, and SSAN.  Check with them first.  

Good luck and may we ALL go on to SVR.  Pat
Blank
Avatar_f_tn
J:  I did not know that the copays were treated just like every other script.  That is interesting (and you are right - I'll bet it drives the insurance companies crazy! : -).  Pat
Blank
Avatar_f_tn
United Health Care.    $15.00. Total
They Rock
...Kim
Blank
Avatar_m_tn
I have BCBS.  

Gilead covered my high deductible this year from their Support Path, so I had only one $5 co-pay.

Arrangements were handled through the excellent pharmacists at Walgreen's Specialty.
Blank
Avatar_f_tn
I was going to delay until thanksgiving, to have the holidays so I could have my mom/husband help me out in case I had major side effects but I may start sooner if it'll mean I'll hit the maximum out of pocket.
We have BCBS and the last time I had to pay 300 for the IFN/Riba/Incivek combo. I am actually HOPING it's around that much, that we can afford. $6000 a month for the 20% copay, we cannot.
Because of our income we will probably not qualify for any assistance, though it would be amazing if we did.
I have a follow-up appointment with my doctor at the end of September so I'm hoping he has some info on this as well.
Blank
Avatar_f_tn
That is how it works for my insurance. Yeah...insurance companies generally don't like the coupons for these high cost drugs. Given that they reduce the cost of the amount of copay that a patient actually pays, a patient is not deterred from using high cost drugs where there are cheaper alternatives (pharmaceutical companies aren't stupid - it is good PR (patient not hurt (has access to the high cost drugs) - and insurance companies still pay the bill - pharmaceutical companies tend to hold the power until such drug's patent's run out)). Jo
Blank
Avatar_f_tn
Note that Support Path sovaldi copay of $5 is not granted based on income (when you apply for coupon - there is no inquiry re: your income). I would not qualify for PAN (which is income-based). That said, I think as long as your income is under 500% of the poverty level, you would qualify (which is pretty liberal).
Blank
7469840_tn?1409849436
I have Tricare Prime, and mine was $17.00 per month, the Sovaldi came through Express Scripts.
Blank
Avatar_f_tn
Cigna specialty pharmacy + PAN foundation.  They BOTH rock.  Cigna picked up about 80% of the cost and the PAN foundation picked up the rest to where I have no co-pay.  That on the triple treatment with Sovaldi + Peg and Riba.  I feel so blessed that it all worked out like that for me. I know some don't believe, but I have to say, Praise be to God!  Susan400
Blank
6708370_tn?1418197421
I paid just the regular copay for my Sovaldi/Olysio which was $ 30 for each prescription delivery

Interesting, the cost was the same for me for a 2 weeks supply as for a 6 week supply. $ 30 copay. They did not send the entire prescription at once - in case they changed their minds I guess - or I had a negative reaction that would warrant stopping treatment

However, the amount that I have paid in excess of what was paid for by Kaiser, colonoscopy, endoscopy, labs, labs and more labs, co-pays for doctor visits, etc

I spent about $ 5,000 in the last 6 months for these things
I just don't know how people can afford a $ 225,000 treatment!

Blank
Avatar_m_tn
Sovaldi, in some of their help/suponrt web pages, states the $5 coupon is good for a "12-week regimen of SOVALDI."  I am doing 24 weeks of Sovaldi, however, and they have sent me a letter twice that said the $5 coupon will be honored all 24 weeks of treatment.  
Blank
Avatar_m_tn
Okay, the website also says "The coupon can be applied to up to 6 fills."  Great deal.
Blank
Avatar_f_tn
I feel very fortunate that my husband gave 20 years to the military. We have Tricare and I paid a whopping $17 total for sov/riba.
Blank
Avatar_f_tn
I have Cigna health spring an so far, I haven't been billed anything..  They have denied a different GERD medicine that was approx. $20 more than my old GERD script..  So I was pleasantly surprised when they didn't refuse to pay for treatment..  I really think it had a lot to do with my doctors office knowing exactly what the insurance company required, but of course, that's a guess
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Hepatitis C Community Resources
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
Top Hepatitis Answerers
446474_tn?1404424777
Blank
HectorSF
CA
1815939_tn?1377995399
Blank
pooh55811
476246_tn?1418874514
Blank
Marcia2202
Copenhagen, Denmark
317787_tn?1373214989
Blank
Dee1956
DC
163305_tn?1333672171
Blank
orphanedhawk
Rural Mural, CA
96938_tn?1189803458
Blank
FlGuy
South, FL