Well, after a long wait for the protease inhibitors to get FDA approval, my bubble of hope was shot today. I have Blue Cross Blue Shield.Incivek is considA 30 day script is $16,000. Incivek is considered a non prefered drug by them and so I must pay 50% of the cost out of pocket. Vertex does have a copay help program which give a 20% copay help. After a 20% copay card from Verrtex, my out of pocket, roughly $14,000 for a 12 week treatment. I just cant afford this. Is anybody working on a drug coverage appeal for Incivek or have you found other means of assitance?
Perhaps you might want to consider having the IL28b allele testing at Labcorp to see which genotype you are ... Interleukin 28B (IL28B) Polymorphism (rs12979860)
If you happen to have the CC allele the old SOC - P/R (peg/riba) Tx regime gives about as good odds of clearing as the triple tx for allot less investment and risk ...
Just because you can't afford the triple tx doesn't mean you are out of options !
The triple tx also has extra sx + risk of resistance issues .. especially the long term effect of the resistance / viral mutation issue ... to me, it is a serious issue in which the long term mutation effects have not been well researched. There is to date, very little data on resistance/mutations. Also many doctors have not yet been trained / had experience with them ...
Here's a pretty good recent article on why triple tx is "Not that Simple"
BCBS has gotten out of hand recently. My insurance premiums are over $1,000 a month and a few days ago they wouldn't pay for a bottle of cough syrup for my daughter and yesterday they tried not to pay for my diabetes meds.
I think I need to spend some angry time on the phone.
If the PI's are not affordable ... for whatever reason ... what's the solution ?
The OP already said:
"I have Blue Cross Blue Shield.Incivek is considA 30 day script is $16,000. Incivek is considered a non prefered drug by them and so I must pay 50% of the cost out of pocket. Vertex does have a copay help program which give a 20% copay help. After a 20% copay card from Verrtex, my out of pocket, roughly $14,000 for a 12 week treatment.
I had called Vertex when I started they worked on getting it into my pharma and my ins. paid for it . I have not even been asked for a copay, don't know why, figure the less I ask the better right now..I would call Vertex directly and they may help you.
They will allow Victrelis which is my preference of the two and I suggest going with that one unless there is some reason not to. I think bcbs is being pretty silly about this in that the Incevik is taken only for 12 weeks and the Victrelis will be taken (in my case) for 44 weeks. They are using a company - Prime Therapeutics - to review all of their prescriptions. They are showing the total cost of a 30 day supply of Victrelis at $4836.85 and my cost (which varies between their wide range of premiums) is $60. So 4836 x 11 months is $53,196 which is actually more than $16,000 x 3 ($48,000).
I'm so disturbed to hear what your out of pocket will be for treatment. It doesn't make any sense to me that people cannot afford the care needed.
Hopefully you can get the assistance and I would think what matters is what you are making now.
It is so disgusting that most of the planet is struggling financially while the top 1% are swimming in champagne. Its sad when a piece of gold or a piece of paper is worth more than a human life.
I stay hopeful because of the help that is out there.
I need to correct what I said earlier. I am paying a co pay for the incivek of $50 dollars a month.The other two drugs were 30 and 20 copay. Somehow I got that confused because I thought the co pay was going to be higher. Sorry for that misunderstanding.....
I am glad to hear that BCBS has come around! I am on BCBS and was planning to use VIC anyway but they would not have approved Incevik - at that time - without that huge copay for me. I am so glad you have had success here.
Good luck going forward. I hope you can start soon.
I am so sorry to hear of your news, I personally just went though the same thing with my Humana insurance, which is Medicare Part D. My monthly cost of Incivek is $16,000 , thats $48,000 for 3 months. I am not even going to go into Riba & Peg. However, this is who I contacted and got assistance with and they can help you too. This was help for all three drugs and all of them gave a substantial amount on my benefit for co pay relief for HCV
Chronic Disease Fund 1-877-968-7233
Patient Access Network Foundation 1-866-316-7263
Patient Advocate Foundation Co-pay Relief 1-866-512-3861
God Bless You and I hope you find some peace with this information Carrie
Also, make sure you get in touch with your Doc and make sure you let them know what you are doing. They should be working with you on this. Also, make sure you find out who your specialty pharmacy will be. Along with tax returns, insurance cards , medicare cards, Ect. Some will want it some wont.
Also, Your Doctors office and Specialty Pharmacy should have access to most of all these foundations and can help you with the Cordination of benefits and other information. I was to start treatment in early June and was delay until Sept 12, because my doctors office never ran the meds first. All I knew was everything was cool and I was to start, until I found out I had $5000. a month co-pays. LOl All will work out ! Hugs
Patient Advocate Foundation Announces $9.3 Million Donation to their Co-Pay Relief (CPR) Program
Friday, December 9, 2011
Posted by New HCV Drugs
FILE UNDER DRUG ASSISTANCE PROGRAMS
WASHINGTON, Dec. 9, 2011 /PRNewswire via COMTEX/ -- Additional Funding to CPR Program Will Serve Nonsquamous Non-Small Cell Lung Cancer (NSCLC), Breast Cancer, Colon Cancer, Rheumatoid Arthritis, Hepatitis C Patients in Need of Financial Assistance
Patient Advocate Foundation (PAF) is pleased to announce that it has received a $9.3 million contribution, from an existing partner, providing further support through its Co-Pay Relief Program (CPR) for patients suffering from nonsquamous non-small cell lung cancer (NSCLC), breast cancer, colon cancer, rheumatoid arthritis and hepatitis C who are unable to afford their medical co-payments. These funds are currently available to qualified patients.
PAF's CPR Program provides direct financial support for pharmaceutical co-payments to insured patients, including Medicare Part D beneficiaries, who financially and medically qualify. Since the program's inception in April 2004, CPR has distributed more than $130 million in assistance to more than 50,000 patients nationwide who were unable to afford their pharmaceutical co-payments.
"The Co-Pay Relief Program was developed after PAF recognized extreme increases each year in the number of patients seeking pharmaceutical co-pay assistance, despite the fact they were insured," said Nancy Davenport-Ennis, Founder and CEO of PAF. "Battling any disease is difficult, particularly now with the high out-of-pocket expenses that are routinely incurred by patients. Thanks to this extremely generous donation, we will be able to offer an even greater level of support to patients seeking help with their pharmaceutical co-payments."
On August 1, 2011, PAF announced a new operational model for CPR that serves more patients, provides enhanced service to both providers and patients through new technology tools, and allows for many more patient approvals. CPR donations are now released in total into each disease silo immediately upon receipt, rather than dividing contributions across a twelve month period. CPR accepts all qualified new and renewal applications on a first come first serve basis with no limit imposed on the number of approvals issued monthly. CPR also accepts and processes all expenditures on a first come, first serve basis until the available funds in the entire silo are exhausted. Eligible expenditures may be submitted by patients, providers and/or pharmacists.
"We are excited about CPR's use of state-of-the-art technology solutions to deliver a high degree of automation and efficiency to program users. For example, electronic signature and file upload capabilities have been integrated into both the online application and the expenditure submission processes, including the capability for a user to fax documents which use a barcode based routing system," said Beth Patterson, President of Mission Delivery, and Fran Castellow, President of Operations. "These technological enhancements allow the patient, provider and pharmacy communities to leverage existing Electronic Health Records (EHR) or their Health Information Technology (HIT) to increase the speed with which their expenditures and applications are processed. In addition, CPR still has secure web-based portal access 24 hours a day, online assistance capabilities and live assistance via the toll-free phone number."
Patient Advocate Foundation and its companion organization, the National Patient Advocate Foundation (NPAF), were founded on the principle that health care is a basic human need and shared social responsibility. Annually, PAF receives thousands of contacts requesting information and assistance via their toll-free hotline, as well as online, with complete direct, sustained case management services provided to patients from all fifty states free of charge. For more information about PAF, visit www.patientadvocate.org or call toll free (800) 532-5274. For more information about PAF's Co-Pay Relief Program visit www.copays.org or call toll free (866) 512-3861.
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