Please Help Me Determine Best Tx Plan.

[Carlhcv]

Hello old friends and new. I haven't been on here in awhile. I have Hep C, 1a. I could not afford health insurance and the affordable health care act ended the compassionate care programs from the drug companies. Now my financial situation has improved due to an inheritance. The insurance exchange is supposed to reopen next month. I will purchase one of the premium plans that is approving the new drugs. My Drs. office recommends Blue Care Network. My Dr. calls me a prior "partial responder" since my viral load went to barely detectable but rebounded after 24 weeks of Ribavirin/PegInterferon/Victrellis. Now comes the part that I need help with. My Dr. wants to treat me with 24 weeks of Sovaldi/PegInterferon/Ribavirin. He says that Olysio is worthless. I thought that Olysio/Sovaldi would be the best drug combination for me. What combo is working best? What would be best for me? Should I find a new doctor. Please, I need to move on this as fast as possible and lose this virus. Also, what insurance companies are approving the new drugs. Thank you so much in advance.

[Livelife777]

Good evening Carl and Congragulations for getting the ball rolling.
Do know that the future is bright, and with approval and Tx this deadly virus
will be put to rest.
Best wishes
.....Kim

[tobila]

Gilead, the drug company that makes Harvoni can help you to get Harvoni, which, along with being very effective, is very expensive. They can help you appeal a denial from your insurance company and, perhaps more importantly, can give you the drug for free if your insurance company denies your claim and you make under $100,000 a year. Check out www.mysupportpath.com

Good luck!

[Dee1956]

Hey Carl, so good to see you!  So glad you are not trying Interferon again.
I am very happy for you
Take Care
D

[Carlhcv]

Thanks guys, You're the best!

[dontworry_behappy1]

Hey Carl!  That's great news.  Your going to beat this now.   Lots easier than last time for you.  Looking forward to your SVR.

Best to you

[thruwithhep]

Good Luck to you and I am sure when your new insurance kicks in you will be able to get a good treatment! I treated with Solvaldi/Olysio since Harvoni was not available for me in August. I am on medicare from disability and all I had was a prescription supplement with Humana and Wal Mart and got approved for SOL/OLY quickly even though I had to appeal for the Olysio, that was only a week to obtain. I agree with you that Harvoni is a good route to start. I had absolutely no side effects and felt better with in a few weeks.

[Carlhcv]

I just obtained the absolute best insurance through healthcare.gov. Premium Blue Cross that will hopefully approve me for 24 weeks of Harvoni! Glad to see others here getting good early results.

[NYCMark]

As many others have stated here, your current doctor is wrong to dismiss S/O treatment.  I too was cured (SVR24) on that combo after having relapsed on interferon/riba based treatments multiple times in the past.
Good luck with new insurance. The fact that the insurance is a "good" one might not help much, at least initially, with getting them to authorize one of the new all-oral treatments.  Insurance companies use pharmacy-benefit managers, and together they come up with rules to decide who gets the newer expensive treatments.  Having a GOOD experienced hepatologist and staff can help here, as they know how to apply for these drugs correctly, and how to manage appeals if they become necessary.
Mark

[hoping53]

As patra stated, you don't want to go back to interferon. Hepatitis central in the delphi forums http://forums.delphiforums.com/liverfailure/messages/?start=Start+Reading+%3E%3E
This is a very good informational forum with very knowledgable people who have been through everything you could think of. Check it out. Hector is a good persont to PM and he is very good about answering questions and sharing his experience. I just started the Olysio/Sovaldi treatment yesterday. I believe in my doctor and think it is a very good treatment. I am post liver transplant so will do what he recommends. Good luck to you. Hopefully you and I will both be cured soon.

[Carlhcv]

I will most likely be changing doctors. I am right now waiting for a call back from the doctors staff member who assists patients with insurance and tx info. I have the cash put away to purchase a premium health insurance plan as soon as the exchange goes back on-line. This doctor is very kind and generous but his knowledge on txing hep C is definitely lacking. I'm going to try to get more insurance companies to choose from and find out if this doctor might reconsider his tx plan. Thank you all so much. I will hopefully be able to treat soon and will be more active on this forum. The collective knowledge here is priceless, as is the support. Best wishes to all who are still infected in beating this virus. I love you all. :)

[lb141]

I am surprised that a medical doctor would make a statement that "Oylsio is worthless". That would cause me to look at him a little sideways.I took the Sovaldi/Olysio combination in Jan. 2014 and completed 12 weeks in April of the same year.I was 1a and had negative ultrasounds.I treated in 2002 with Peg,In,and Ribavarin...and had to stop because of the awful side effects.As of now,I am SVR...and this is my six month eot results...maybe you should find another doctor...or at least ask some more questions...

[Carlhcv]

Great info! I think that 24 weeks of Harvoni is my best tx option. Maybe 12 weeks but I want to give myself the best chance of cure this time around. As far as insurance, I guess I will discuss it more with my present doctor's insurance specialists. Then a new doctor is in order. I appreciate this help so much.

[Willy50]

For genotype 1A Harvoni will provide equal SVR rates, but without RBV, but yes, the cure rates with either regimen will be very good; far batter than an interferon based combo

[flyinlynn]

I think the Abbvie 3D as I read it is called will include the use of Ribavirin which could be problematic for those of us with lowered platelet counts and cirrhosis.

[hrsepwrguy]

"They have a Harvoni like pill with the same ingredients I was told by AbbVie Pharmacist."

As Longman sees it, AbbVie should contemplate a $76,000 price tag – or a 20% discount – for the simple reason that its own hepatitis C treatment, which is expected to win FDA approval shortly, is not as convenient. The treatment requires taking more pills more frequently, including Norvir, another AbbVie drug that can also cause interactions with other medicines.

For this reason, Longman says the AbbVie triple combination treatment scores poorly on a proprietary ranking system when compared with Harvoni – 14.6 versus 18.3 – based on safety and use. Overall, he says the drugs scored comparably – Harvoni registered 39  versus 37.2 for the AbbVie treatment – only because their efficacy rankings were fairly similar.

http://blogs.wsj.com/pharmalot/2014/10/14/if-abbvie-discounts-its-hep-c-drug-would-pricing-reach-a-tipping-point/?mod=yahoo_hs

[keepingOnkeepingOn]

I'm 1a and on S/O. I've reached UD. Yeah S/O! EZ PZ as I'm coming down the home stretch of a 12 week run. Who said that Olysio was no good? That's an opinion. Ask those being cured by the S/O combo if it's no good. Your doc is outdated.
As for what Ins Co to choose, I'd call around locally and see if they give out lots of approvals (or denials) for treatment and ask about their Ins plans. That'll take research. It may be state based.

Harvoni may be your way to go as was mentioned. By the time you get all set up with Ins and new docs with new labs you'll be ready to treat. I'm hearing Jan 1 is the big day for AbbVie. They have a Harvoni like pill with the same ingredients I was told by AbbVie Pharmacist. The price will drop when they step in to become competition to Gilead et al. So Glad you can treat again. Take it one step at a time and you'll be ok.

[hrsepwrguy]

"Is it too new to know what cure rates they are seeing with it?"

Study ION - 2:
Response Rates after 12 and 24 Weeks of Treatment in Subjects with Genotype 1 CHC with or without Cirrhosis who Failed Prior Therapy

HARVONI 12 Weeks (N=109)

SVR 94% (102/109)

HARVONI 24 Weeks (N=109)

SVR 99% (108/109)

http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf

[Carlhcv]

Thank you so much. I am soaking this up. This gastroenterologist has been seeing me at discounted rates but has shown lack of knowledge in the past and he did make mistakes in my prior tx. When I get insurance I can find another Dr.
This Harvoni sounds like my best bet. Enough members here whom I trust have verified that I shouldn't do interferon and that is what I thought also so no interferon.
Harvoni is Sovaldi and Ledipasvir and sounds like the drug for me. Is it too new to know what cure rates they are seeing with it?
Don't worry, great news that you beat hcv! I will look into Hep C.com.
I do not know if I have cirrhosis or fibrosis. I don't have any symptoms.
That leaves the question of insurance companies as I'm told that some are denying coverage for these new drugs.
I will be first in line when the health insurance exchange goes back up. I will have the $ to buy a good plan.

[Livelife777]

In agreement with everyone pertaining to Tx.  Unfortunately your Dr needs to head back to Med School.  They actually are going to be taking Interferon off the market especially for Cirrhotics. The majority of the population infected with Hep C are genotype 1.   The current clinical trials focused their Tx strategy's on your genotype and Harvoni was the protocol. This regimen was FDA approved Oct 10th and should hit the pharmacy shelves within 6 weeks.

My best to you and finally getting rid of this virus.
.....Kim

[Willy50]

I'm sorry, your doctor may be a good man, a good GP, but he is not giving you good advice on this. If you are treating anything HCV related I'm afraid he has shown you need a new doctor. I would be concerned that any other HCV related care he provides is several years behind times.

First, are you cirrhotic?
If you are cirrhotic and a past TX failure you should treat for 24 weeks, without IFN or RBV. Cure rate in trials was 100% w/ this protocol. (I believe)

If you are ONLY a past TX failure non-cirrhotic it should be 12 weeks w/o IFN or RBV

Olysio and Sovaldi just cured my friend who failed TX 3 times prior, once w/ incivek, and no RBV.

There were large numbers of advanced stage past TX failures who succeeded with Olysio and Sovaldi.

IMHO; your doctor is wrong, very very wrong, and on several counts.

~W

PS Carl; Harvoni is one pill comprised of Sovaldi and Ledipasvir. The duo is called Harvoni. Sovaldi will continue to be a stand alone pill (earlier called sofosbuvir, and earlier still GS 7977)

[AWorriedMom]

I strongly suggest that you do not do any more interferon. It obviously does not work well for you. I also wonder why your doctor would even make that recommendation when the best treatments are the all oral ones. I suggest you look at Harvoni or if you want to wait, the Abbvie drugs should be approved in the next couple of months. I cleared on the Abbvie drugs after years of trying different combinations of interferon based treatments. I also am a 1a with cirrhosis and have a lot of confidence in the Abbvie drugs. I am not positive but I believe they are the only ones that were extensively trialed with cirrhotic patients and we are the hardest to clear. The SVR rate in my group was 96%.

[hrsepwrguy]

Recommended Treatment Duration for HARVONI in Patients with CHC Genotype 1

Treatment - experienced** without cirrhosis
12 weeks

http://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf

[dontworry_behappy1]

I found this site that you can sign up for an action plan.  HepC.com.
If I was thinking out treatment again... I would sign up for the action plan.  
I believe you will get some great info.  I was impress that the "find a doctor" on this site listed many of the treating doctors by zip code.  

Yes I did clear and living the "no hep c" life after Incivek.  Boy was that a roller coaster ride.   Try staying away from interferon.  I think that's the ingredient that makes past treatment so hard.

You can do this Carl

[Carlhcv]

Hi, good to hear from you again! Have you cleared yet? Yes, I was concerned about the interferon too. It was very harsh but I can do it again if it is my best option. I just question if it IS my best option. What tx is working best for people now?