Huge Express Script News - A Christmas Miracle

[AWorriedMom]

Ok, I am so thrilled (and tearful) to give you guys this news. I just got off the phone with Express Scripts. They have assured me that anyone who cannot take the Abbvie drugs (sovaldi relapsers) can, with prior authorization asked for by their physician, will get Harvoni. The following phone number is where your doctor can call to get prior authorization. 1-800-935-6103. And, that prior authorization will be had in 48-72 hours. Thank you Express Scripts for doing the right thing.

*Disclosure - I have no way of knowing if the woman from Express Scripts was completely forthcoming. She seemed totally knowledgable and caring. And she told us she was reading the information right off her screen for what is happening starting 1/1/2015.

[flyinlynn]

Was trying to add
Also my low platelet count of 80 to 90 range as well as enlarged speen both signs of portal hypertension

[flyinlynn]

Hi Sarah
Yes you would think having cirrhosis for 7 years plus esophageal bending, pitting edema, and a small amount of ascities I should have qualified. Also my  The reason for my initial denial was because Sov Oly was off label use as of last March when I started taking it.

Best to all
Lynn

[chrissy983]

I have auto-immune diseases. Maybe that could be it? Lupus, RA, Dermatomyositis.

[Mmorgan856]

hey!!!  Congrats on the undetected VL. Sounds like you're on the path for 2015 to be " YOUR " year you beat this.. Way to go...take care.  Mary

[Sarah1949]

Lynn, I think the only reason I got approval for S/O was because I have neuropathy caused by Hep C, along with the cirrhosis. The treating criteria says something about having to have cirrhosis plus one ailment -- like ascites, varices, or neuropathy.

My platelets were 65 before starting S/O. Last labs they were up to 85.

WM, I distinctly remember the doctor saying she didn't want me on Riba cause of my low platelets. And that was how I got the Olysio. Of course maybe she was mistaken.

[Ekkiemom]

Wow Linda, way to go girl!  So happy for you results you must be sooo excited one more Christmas present for you. Wishing you speedy and everlasting SVR
Warm Holiday Wishes
Deb

[HealingHearts]

Anyway you look at it, no one wants ribavarin!

[Ekkiemom]

AWESOME NEWS!  This is a relief for everyone.....time to exhale folks. Thanks for sharing AWM. I was worried in case I needed a plan B
Merry Christmas
Deb

[AWorriedMom]

Are you sure that your doc didn't want you to take riba because of low platelets? Platelets are lowered by interferon. Hemoglobin is lowered by ribavirin.

[flyinlynn]

Hi Sarah
I sent a message to my doctor about addng riba I just finished week five on Harvoni but I also have low platelets about 80 to 90 range. I haven't head back from my doctor yet but just wondering how low your plateletts are?

I haven't had the same experience with express scripts as you. Although I have had cirrhosis since 2008 I was initially denied Sovaldi and Olysio and spent lots of time on hold trying to get it resolved. Now with Harvoni same experience until I made a comment on a Express Scripts professional web site to an article they had they had me contact an email address and they called me the next day. Ever since it has been ok but previously I couldn't get passed the customer service people that did not know how to say sofosbuvir.

Best to all
Happy Holidays
Lynn

[Sarah1949]

I have Express Scripts and have found it depends on who you talk to what info you get. When I had questions about Sovaldi the main customer service number knew nothing and I learned to ask for the speciality dept who knew everything. I really am glad to hear this because I've been extremely happy with ES. They have not denied me one drug and my co-pays are extremely reasonable. They even pay for Xifaxan, a drug some plans don't pay for.

As far as Riba goes, my doctor didn't want me taking it due to my low platelets. Anyway, great news WM.

[AWorriedMom]

I wish people would understand that ribavirin is mostly a problem when people take it with interferon. The vast majority of patients taking it with the new DAA's do not have serious drops of hemoglobin or any other severe side effects. People are being frightened for no good reason.

[HealingHearts]

Yes Lynn, do something to celebrate...you deserve it. Fighting hep c is the hardest thing I have ever had to do. In 3 weeks, I will be half way thru Harvoni treatment and will find out if I'm UD. Can't wait!

That said, can't say that's good news about the Express Scripts dropping Harvoni. Reason being is the new Abbvie drugs for the GT 1 people will require taking ribavarin. Harvoni gave me no side effects at all and I am blessed to be taking it. I hear Ribavarin is no fun.

[hepcandme]

That is SO wonderful Lynn!

Congrats!

~ Linda

[AWorriedMom]

WOO HOOOOO! That is such great news, Lynn. Doesn't it feel amazing? I couldn't believe it when I got my first undetected. It took me weeks to believe it. I am very happy for you.

[flyinlynn]

I sure hope so I just got my 4 week viral load back

HCV RNA QT UNDETECTABLE

5 weeks complete hopefully 19 weeks to go

[AWorriedMom]

David just probably hasn't been asked the question yet as all of this has just come about. I talked with someone in the corporate office and she went a step beyond for us and spent about 15 minutes looking in to what was going to happen. Late yesterday I saw a press release that confirmed what she told me so I am feeling more confident that all of you sovaldi, Harvoni guys are going to be just fine.

[keepingOnkeepingOn]

The liver is not likely to give a person pain. Is there some other reason for the "pain" you are experiencing? Maybe it has something to do with being pregnant?

[hepcandme]

Heard on NPR today that Gilead's stock had plummeted by 15 points?

Clearly, things are in flux at the moment. I think it would a surprise to most people to learn that insurance companies can, and do, determine what drugs are on offer to patients. One would assume that whatever regimen is best for the patient is the one that will be offered to them. But we know, from our friends here, that if you are on Medicaid or are a veteran, you are often relegated to Interferon based treatments - simply because that is the only treatment offered

I can't imagine that it will make much of a different to those who have already begun treatment with Harvoni. It would certainly be bad PR for Express Scripts to not pay attention to data showing efficacy with Harvoni.

Keep us posted and thanks for the holiday hold time Mom. Trust you got to listen to some Christmas carols

[chrissy983]

that's good to know! was worried for a second, as I have epilepsy and cant drive. =] ty for clearing that up!

[dontworry_behappy1]

Hepatitis C treatment drugs are offered though speciality pharmacies.  The treatment drugs are mailed to your home.   Caremark is the CVS specialty pharmacy.   You will get them no matter where you are.

Best to you

[chrissy983]

hopefully they cut a deal with more than just cvs. there isn't a cvs for nearly 50 miles around me! we have privately owned pharmacy's in my town.

[can-do-man]

Gilead Sciences Inc. (GILD) may finally be forced to offer a lower price for its $94,500 hepatitis C drug.

The biotechnology company could have no choice but to negotiate its own discounts with CVS Health Corp. and other drug benefit managers, say analysts, after rival drugmaker AbbVie Inc. (ABBV) announced a deal today to block Gilead’s pill Harvoni from a list of medicines covered by Express Scripts Holding Co. (ESRX)

Express Scripts manages pharmacy benefits for about 85 million people in the U.S., while CVS had about 26 percent of the pharmacy benefits market in the U.S. last year, behind Express Scripts, according to the U.S. Department of Labor.

“Does Gilead really want to be blocked from half of the U.S. population?” John Kreger, an analyst at William Blair & Co., said in a telephone interview today. “They would be the most motivated to cut a deal with CVS.”

AbbVie’s deal with Express Scripts flips the power balance to favor insurers and pharmacy managers, who now can pit drugmaker against drugmaker to force price cuts in one of the most expensive classes of medicines in history. AbbVie’s treatment, without the multiyear discount it has given to Express Scripts, costs $83,319 for a 12-week course, or about $1,000 a day.

The result will be “a domino effect,” said David Bernstein, chief of hepatology for the North Shore-LIJ Health System, as each drugmaker strikes its own deal to be a pharmacy manager’s medicine of choice in return for discounts. Bernstein has worked as a consultant for Gilead and AbbVie.

http://www.bloomberg.com/news/2014-12-22/will-cvs-join-the-fight-over-1-100-hep-c-pill-.html

[chrissy983]

Def does. I think ill feel better about it once I see the actual hepatologist. I tested for the antibodies, but she wasn't clear on the rest. just said my levels were normal and nothing detectable. but she was just a nurse practioner, that's it. tbh I would have NEVER known about it if I wouldn't have gotten pregnant!

I do have the side pain though. off and on. green tea helps the most with that though, which my one dr said is good for the liver. =]