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.
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.
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.
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.
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
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).
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
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!
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.
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
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